Muscle Disease Flashcards
What is the key investigation for myositis?
Increase in creatine kinase (found within muscle cells and released in high quantities when muscle is inflammed)
What is the difference between polymyositis and dermamyositis?
Polymyositits - chronic inflam of muscle
Dermatomyositis - chronic inflam of muscle AND SKIN
What cancers are associated with poly/dermamyositis?
BLOG Breast Lung Ovarian Gastric/Colon
Describe the pain and location associated with poly/dermamyositis?
When is a patient likely to notice?
Insidious onset over weeks
Symmetrical WEAKNESS
Proximal muscles - shoulders + pelvic girdle
Notice whilst climbing stairs/hanging up washing etc.
How does dermatomyositis present cutaneously?
Gottron lesions - red/purple colouration over MCP/PIP
Shawl sign - erthymatous V-shaped rash over chest
Heliotrope rash - red/purple rash over eyes + ~oedema
What is the most definitive test for polymyositis?
Muscle biopsy
What antibodies are associated with polymyositis?
ANA
Anti-SRP
Anti-Jo-1
How is polymyositis managed?
Prednisolone - reduced down slowly
+ immunosuppressant
Who is more likely to present with polymyositis, males or females?
Females
What is fibromyalgia?
An unexplained condition which causes widespread muscle aches and pains
Thought to be due to issue with central pain processing -> can lead to increase sensitivity to heat, noise and smells
What conditions is fibromyalgia associated with?
50% of SLE
25% of RA go on to develop fibromyalgia
Also associated with IBS, depression and migraines
What 3 criteria are needed to diagnose fibromyalgia?
What symptom is very suggestive of fibromyalgia?
Clinical diagnosis from a history consistent of fibromyalgia
- 3mnths+ of chronic bilateral pain, above and below waist and including axial skeleton
- chronic fatigue and problems sleeping
- cognitive difficulties
SLEEP PROBLEMS
How is fibromyalgia managed?
Management of chronic conditions
- atypical analgesics may be used
- CBT therapy
- EXERCISE
Patients can be very difficult to manage
(some dispute its not a real condition)
Describe the pain associated with polymyalgia rheumatica (PMR)?
2 weeks+ Bilateral shoulder + pelvic pain (sometimes cervical spine too) Disturbs sleep Worse on movement AM stiffness 45+ mins
(strange as has mixed pattern of inflam/non-inflam pain)
Who most commonly presents with polymyalgia rheumatica?
50+ Caucasian females
