Muscle diseases Flashcards
what is polymyositis
idiopathic inflammatory myopathy
are females or males more likely to get polymyositis
females
what age group of females are most likely to get polymyositis
40-50
what is dermatomyositis
polymyositis + skin involvement
how does the skin present in dermatomyositis (3)
shawl sign/v shaped rash heliotrope rash (red/violet rash on eyelids) gottrons papules (scaly erythematous lesions on knuckles)
where do gottrons papules present in dermatomyositis
knuckles
where does a heliotrope rash present in dermatomysitis
eyelids/face
presentation of polymyositis (4)
muscle weakness (progressive) in proximal, large muscles
symmetrical
weight loss
myalgia (muscle pain)
difficulty climbing stairs, brushing hair etc
investigations for polymyositis
muscle biopsy EMG CK raised inflammatory markers raised autoantibodies
gold standard investigation for polymyositis
muscle biopsy
autoantibodies in polymyositis
ANA
anti-jo1
treatment of polymyositis
steroid - prednisolone 40mg
immunosuppressant - methotrexate, anti-TNF
complications of polymyositis
increased risk of malignancy
what is inclusion body myositis
similar to polymyositis but not as much inflammation
where does inclusion body myositis present (2)
distal muscles eg wrists, hands
asymmetrical
prognosis of polymyositis
good if treated
what is the treatment of dermatomyositis
same as polymyositis
steroids - prednisolone 40mg
immunosuppressant - methotrexate
which group of people is inclusion body myositis common in (gender and age)
men >50
what is the treatment of inclusion body myositis
same as polymyositis
steroids - prednisolone 40mg
immunosuppressant - methotrexate
what is polymyalgia rheumatica
idiopathic, inflammatory myopathy
which rheumatological condition is polymyalgia rheumatica associated with
giant cell arteritis
is there muscle weakness in polymyalgia rheumatica
no
presentation of polymyalgia rheumatica
NO muscle weakness
ache in shoulder/hip
morning stiffness >1 hour
how long does morning stiffness last in polymyalgia rheumatica
> 1 hour
what mental health issue is associated with polymyalgia rheumatica
anorexia
what is the only abnormal investigation in polymyalgia rheumatica
inflammatory markers - CRP, PV
what are the general investigations for muscle disease
muscle biopsy
inflammatory markers - CRP, PV
CK
muscle power test
which investigations are normal in polymyalgia rheumatic
muscle power
muscle biopsy
CK
is there inflammation in polymyalgia rheumatica
no
treatment of polymyalgia rhuematica
steroids - prednisolone 15mg (reduce over 2 years)
is polymyalgia rheumatica curable
yes
how long does it take to cure polymyalgia rhuematica
2 years
what supplements do you need to give when treating polymyalgia rheumatica with steroids (3)
why
Ca
bisphosphonate
Vit D
osteoporosis prevention
what is fibromyalgia
idiopathic non inflammatory muscle pain
‘nothing is wrong with them’
what GI condition is fibromyalgia associated with
IBS
is fibromyalgia common
yes - 5% of population
which group of people is fibromyalgia most common in
young women
what mental health issue is fibromyalgia associated with
depression
presentation of fibromyalgia (6 + location)
general aches and pains (esp neck, shoulder, lower back) soft tissue tenderness fatigue depression abdo pain (IBS) headaches/migraines
examination in fibromyalgia
18 fibromyalgia tender points
diagnosis of fibromyalgia
history and 11/18 fibromyalgia tender points
what tests are normal in fibromyalgia
all
inflammatory markers muscle biopsy
antibodies
muscle power test
CK
treatment of fibromyalgia (4)
nothing
patient education - no cure
pain relief - gabapentin
anti depressants
acupuncture
what is the same about polymyositis and polymyalgia rheumatica
idiopathic inflammatory myopathy
what is different about polymyositis and polymyalgia rheumatica
no muscle weakness in polymyalgia rheumatica but there is muscle weakness in polymyosits
