Muscle Disease

Question 1

what does myopathy mean?

Answer 1

muscle disease

Question 2

what are the two inflammatory myopathies?

Answer 2

polymyositis

dermatomyositis

Question 3

who is more likely to suffer from an inflammatory myopathy?

Answer 3

females

ages 40-50

Question 4

what are patients with inflammatory myopathies screened for and why?

Answer 4

malignancies

risk increased

Question 5

what are the clinical features of polymyositis?

Answer 5

insidious onset muscle weakness

myalgia

Question 6

what are the clinical features of dermatomyositis?

Answer 6

muscle weakness

skin involvement

Question 7

what three skin signs are seen in dermatomyositis?

Answer 7

gottron’s sign
heliotrope rash
shawl sign

Question 8

what is Gottron’s sign?

Answer 8

red/purple discolouration over the MCP/PIP joints

Question 9

what is a heliotrope rash?

Answer 9

a red rash around the eyes

may be associated with oedema

Question 10

what is the Shawl sign?

Answer 10

red/purple rash on the top of the back and the front of the chest

Question 11

what other organs are commonly involved in inflammatory myopathies?

Answer 11

lungs
oesophagus
heart

Question 12

what is often raised in bloods in inflammatory myopathies?

Answer 12

CK

inflammatory markers

Question 13

what autoantibodies can be seen in inflammatory myopathies?

Answer 13

ANA - not specific

anti Jo 1 - specific

Question 14

what clinical tests should be done in examination for inflammatory myopathies?

Answer 14

confrontational testing

sit to stand tetst

Question 15

what investigations will be done for inflammatory myopathies?

Answer 15

EMG
muscle biopsy
MRI

Question 16

how are inflammatory myopathies managed?

Answer 16

corticosteroids
immunosuppression
physio as needed

Question 17

who is affected by polymyalgia rheumatica?

Answer 17

almost exclusively >50’s

Question 18

what is polymyalgia rheumatica associated with?

Answer 18

temporal arteritis

Question 19

how does polymyalgia rheumatica present?

Answer 19

ache in the shoulders and hips
morning stiffness
reduced ROM

Question 20

how is polymyalgia rheumatica diagnosed?

Answer 20

clinical diagnosis with raised inflammatory markers

Question 21

what investigations should be done for suspected temporal arteritis?

Answer 21

temporal artery biopsy and USS

Question 22

how is polymyalgia rheumatica managed?

Answer 22

low dose steroids - start prednisolone 15mg daily

Question 23

how is polymyalgia rheumatica with GCA managed?

Answer 23

start prednisolone at 40-60mg daily

Question 24

what is the most common cause of MSK pain in women 22-50?

Answer 24

fibromyalgia

Question 25

when can fibromyalgia begin?

Answer 25

after emotional or physical trauma

Question 26

when can fibromyalgia be diagnosed?

Answer 26

widespread pain and associated symptoms symptoms present for over 3 months no other condition explains it

Question 27

what are the associated symptoms of fibromyalgia?

Answer 27

unrefreshed sleep cognitive symptoms fatigue