Muscle Disease Flashcards
What are some features of polymyositis on muscle biopsy?
Muscle fibre necrosis, degeneration and inflammatory cell infiltrate
Polymyositis and dermatomyositis are idiopathic. True/false?
True
What is the main clinical feature of polymyositis?
Muscle weakness coming on gradually
Name a clinical feature of dermatomyositis
Heliotrope rash
Polymyositis is restricted to muscle. True/false?
False - it is autoimmune and can affect several body parts
What clinical tests can be done for polymyositis?
Confrontational testing (pushes against arm) Isotonic testing (sit to stand)
What blood tests can be done for polymyositis?
Creatine kinase
ANA
Anti-Jo-1
What other tests may be done to diagnose polymyositis?
Electromyography
Muscle biopsy
MRI
Which test is most definitive in diagnosing polymyositis?
Muscle biopsy
How is polymyositis treated?
Glucocorticoid (high dose reduced over time)
DMARDs
Give some differences between inclusion body myositis and polymyositis
Polymyositis is commoner in females, affects proximal muscles and only raises CK slightly
Polymyalgia rheumatica has an association with which condition?
Giant cell arteritis
What are the clinical manifestations of polymyalgia rheumatica?
Ache in shoulder and hip
Morning stiffness
Normal muscle strength
Polymyalgia is a clinical/laboratory diagnosis
Clinical
How is polymyalgia rheumatica treated?
With low dose steroids - has rapid response
What is fibromyalgia?
Chronic musculoskeletal pain not associated with inflammation
Name some conditions fibromyalgia is associated with
Depression
IBD
How does fibromyalgia clinically manifest?
Painful neck, shoulders and lower back worse with exertion, fatigue and stress
Touching a tender area in a patient with fibromyalgia will not cause any pain. True/false?
False - will cause excruciating pain
How is fibromyalgia treated?
Educating patient
Anti-depressants
Analgesia
