Muscle Diseases Flashcards
What presentation is polymyalgia rheumatica characterised by?
Which age group is most commonly affected?
What vasculitic disease is associated with polymyalgia rheumatica?
Characterised by weakness of the pelvic and shoulder girdles
Most commonly affects elderly patients, very rare in people under 50
Associated with Giant Cell Arteritis (approx 40-50% of patients with GCA have polymyalgia rheumatica)
How is polymyalgia rheumatica affected by activity?
Increased activity improves symptoms i.e. condition gets better as the day goes on
Polymyalgia Rheumatica - treatment
How do patients respond?
Low dose steroids - patients respond dramatically (this can sometimes be used diagnostically)
What is the most common form of systemic vasculitis in adults?
GCA
What is the difference between polymyositis and dermatomyositis? Who gets these conditions most frequently?
Polymyositis is idiopathic inflammatory myopathy that causes symmetrical proximal muscle weakness. Dermatomyositis is the same but also has cutaneous features
More common in women (2:1) and in people aged 20+
Peak is between 40-65 years old
What associated presentations may be seen in polymyositis?
ILD - 5-30% of patients
Dysphagia - approx 1/3rd patients
How are polymyositis and dermatomyositis diagnosed?
Anti-Jo-1 antibodies may be seen
Elevated CK may also be seen
Muscle biopsy is crucial!!! Need to exclude other rarer muscle diseases
What are the classical skin presentations associated with dermatomyositis?
Gottron’s papules
Shawl rash
Heliotrope rash
What should also be screened for at the time of diagnosis of dermatomyositis?
Screen for various cancers as dermatomyositis is associated with a high risk of malignancy!!!
Younger patient (more commonly a woman) comes to see you complaining of fatigue, weakness and muscle pain. Pain is constant and widespread with no obvious cause, and they also mention depression and cognitive problems
What’s the diagnosis?
She’s faking!!!
Just kidding… Fibromyalgia
Fibromyalgia - diagnosis and treatment
No specific tests (pain points?) or treatment…
Validate patient’s concerns and help them to self-manage condition
May perform some immunology tests to rule out other muscle dieases
