Muscle Disease Flashcards
what does biopsied muscle affected by polymyalgia rheumatica look like?
normal
myalgia
muscle pain
how do muscle diseases present?
myalgia
muscle weakness/tiredness
stiffness
abnormal blood tests
what are polymyositis & dermatomyositis?
idiopathic inflammatory myopathies
in which sex are polymyositis & dermatomyositis more common?
female
in which age group does the incidence of polymyositis & dermatomyositis peak?
40-50 years
what should a physician be aware of in a patient with polymyositis/dermatomyositis?
increased incidence of malignancy, particularly in dermatomyositis
what is the most common presenting feature of polymyositis/dermatomyositis?
muscle weakness
what is the onset of polymyositis/dermatomyositis like?
insidious, usually worsening over months
what cutaneous signs can you sometimes see in dermatomyositis?
Gottrons sign
Heliotope Rash
Shawl sign
Gottrons sign
red/purple areas over PIPJ & MCPJ
shawl sign
a rash that creates a v at the front of the chest & wraps around back of neck & tops of shoulders
which other organs can be involved in polymyositis/dermatomyositis?
lungs
oesophagus
heart
systemic
which malignancies is the risk of increased in patients with polymyositis/dermatomyositis?
ovarian breast stomach lung bladder colon
confrontational testing
direct testing of power
isotonic testing
30 seconds of sitting to standing
what can you use to treat polymyositis/dermatomyositis?
glucocorticoids azathioprine methotrexate ciclosporin IV IG
in which demographic group is inclusion body myositis commonest in?
men over 50
what’s the commonest clinical feature of inclusion body myositis?
distal muscle weakness
how is the weakness in inclusion body myositis usually distributed?
asymmetrically
which joints are commonly affected by the weakness of inclusion body myositis?
wrist & finger flexors in upper limbs
quadriceps & anterior tibial muscles in legs
what does a muscle biopsy show in inclusion body myositis?
inclusion bodies
in which age group does polymyalgia rheumatica occur in?
50+
what is polymyalgia rheumatic associated with?
temporal arteritis (GCA)
temporal arteritis
inflammation of the vessel wall of the temporal artery
what would a biopsy of a muscle affected by polymyalgia rheumatica look like?
normal
what does polymyalgia rheumatica respond to rapidly & dramatically?
low does steroids
is fibromyalgia associated with inflammation or not?
no
which demographic group is fibromyalgia common in?
women 22-50 years
what can trigger fibromyalgia?
emotional or physical trauma
what common clinical finding would you need to diagnose fibromyalgia?
excessive tenderness on palpation of soft tissues in 11 out of 18 of the “tender points”
