Muscle Disease

Question 1

what does biopsied muscle affected by polymyalgia rheumatica look like?

Answer 1

normal

Question 2

myalgia

Answer 2

muscle pain

Question 3

how do muscle diseases present?

Answer 3

myalgia
muscle weakness/tiredness
stiffness
abnormal blood tests

Question 4

what are polymyositis & dermatomyositis?

Answer 4

idiopathic inflammatory myopathies

Question 5

in which sex are polymyositis & dermatomyositis more common?

Answer 5

female

Question 6

in which age group does the incidence of polymyositis & dermatomyositis peak?

Answer 6

40-50 years

Question 7

what should a physician be aware of in a patient with polymyositis/dermatomyositis?

Answer 7

increased incidence of malignancy, particularly in dermatomyositis

Question 8

what is the most common presenting feature of polymyositis/dermatomyositis?

Answer 8

muscle weakness

Question 9

what is the onset of polymyositis/dermatomyositis like?

Answer 9

insidious, usually worsening over months

Question 10

what cutaneous signs can you sometimes see in dermatomyositis?

Answer 10

Gottrons sign
Heliotope Rash
Shawl sign

Question 11

Gottrons sign

Answer 11

red/purple areas over PIPJ & MCPJ

Question 12

shawl sign

Answer 12

a rash that creates a v at the front of the chest & wraps around back of neck & tops of shoulders

Question 13

which other organs can be involved in polymyositis/dermatomyositis?

Answer 13

lungs
oesophagus
heart
systemic

Question 14

which malignancies is the risk of increased in patients with polymyositis/dermatomyositis?

Answer 14

ovarian 
breast 
stomach 
lung 
bladder 
colon

Question 15

confrontational testing

Answer 15

direct testing of power

Question 16

isotonic testing

Answer 16

30 seconds of sitting to standing

Question 17

what can you use to treat polymyositis/dermatomyositis?

Answer 17

glucocorticoids 
azathioprine 
methotrexate 
ciclosporin 
IV IG

Question 18

in which demographic group is inclusion body myositis commonest in?

Answer 18

men over 50

Question 19

what’s the commonest clinical feature of inclusion body myositis?

Answer 19

distal muscle weakness

Question 20

how is the weakness in inclusion body myositis usually distributed?

Answer 20

asymmetrically

Question 21

which joints are commonly affected by the weakness of inclusion body myositis?

Answer 21

wrist & finger flexors in upper limbs

quadriceps & anterior tibial muscles in legs

Question 22

what does a muscle biopsy show in inclusion body myositis?

Answer 22

inclusion bodies

Question 23

in which age group does polymyalgia rheumatica occur in?

Answer 23

50+

Question 24

what is polymyalgia rheumatic associated with?

Answer 24

temporal arteritis (GCA)

Question 25

temporal arteritis

Answer 25

inflammation of the vessel wall of the temporal artery

Question 26

what would a biopsy of a muscle affected by polymyalgia rheumatica look like?

Answer 26

normal

Question 27

what does polymyalgia rheumatica respond to rapidly & dramatically?

Answer 27

low does steroids

Question 28

is fibromyalgia associated with inflammation or not?

Answer 28

no

Question 29

which demographic group is fibromyalgia common in?

Answer 29

women 22-50 years

Question 30

what can trigger fibromyalgia?

Answer 30

emotional or physical trauma

Question 31

what common clinical finding would you need to diagnose fibromyalgia?

Answer 31

excessive tenderness on palpation of soft tissues in 11 out of 18 of the “tender points”