Muscle Disease

Question 1

What are some features of polymyositis on muscle biopsy?

Answer 1

Muscle fibre necrosis, degeneration and inflammatory cell infiltrate

Question 2

Polymyositis and dermatomyositis are idiopathic. True/false?

Answer 2

True

Question 3

What is the main clinical feature of polymyositis?

Answer 3

Muscle weakness coming on gradually

Question 4

Name a clinical feature of dermatomyositis

Answer 4

Heliotrope rash

Question 5

Polymyositis is restricted to muscle. True/false?

Answer 5

False - it is autoimmune and can affect several body parts

Question 6

What clinical tests can be done for polymyositis?

Answer 6

Confrontational testing (pushes against arm) 
Isotonic testing (sit to stand)

Question 7

What blood tests can be done for polymyositis?

Answer 7

Creatine kinase
ANA
Anti-Jo-1

Question 8

What other tests may be done to diagnose polymyositis?

Answer 8

Electromyography
Muscle biopsy
MRI

Question 9

Which test is most definitive in diagnosing polymyositis?

Answer 9

Muscle biopsy

Question 10

How is polymyositis treated?

Answer 10

Glucocorticoid (high dose reduced over time)

DMARDs

Question 11

Give some differences between inclusion body myositis and polymyositis

Answer 11

Polymyositis is commoner in females, affects proximal muscles and only raises CK slightly

Question 12

Polymyalgia rheumatica has an association with which condition?

Answer 12

Giant cell arteritis

Question 13

What are the clinical manifestations of polymyalgia rheumatica?

Answer 13

Ache in shoulder and hip
Morning stiffness
Normal muscle strength

Question 14

Polymyalgia is a clinical/laboratory diagnosis

Answer 14

Clinical

Question 15

How is polymyalgia rheumatica treated?

Answer 15

With low dose steroids - has rapid response

Question 16

What is fibromyalgia?

Answer 16

Chronic musculoskeletal pain not associated with inflammation

Question 17

Name some conditions fibromyalgia is associated with

Answer 17

Depression

IBD

Question 18

How does fibromyalgia clinically manifest?

Answer 18

Painful neck, shoulders and lower back worse with exertion, fatigue and stress

Question 19

Touching a tender area in a patient with fibromyalgia will not cause any pain. True/false?

Answer 19

False - will cause excruciating pain

Question 20

How is fibromyalgia treated?

Answer 20

Educating patient
Anti-depressants
Analgesia