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MSK > Muscle Diseases > Flashcards

Muscle Diseases Flashcards

1
Q

What are inflammatory myopathies characterised by?

A

Weakness

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2
Q

What is polymyalgia rheumatica characterised by?

A

Pain and stiffness

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3
Q

What is fibromyalgia characterised by?

A

Pain and fatigue

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4
Q

Define myopathy

A

Disease of the muscle in which the fibres do not function properly

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5
Q

What condition is polymyositis often associated with?

A

Dermatomyositis

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6
Q

What causes polymyositis?

A

Idiopathic, autoimmune inflammatory myopathy

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7
Q

Who tends to get polymyositis?

A

40-50 year old females

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8
Q

State the increased risk in men with polymyositis

A

> 45 years old increased risk of malignancy

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9
Q

What are the clinical features of polymyositis?

A

Muscle weakness, insidious onset worsening over months, symmetrical pattern affecting proximal muscles

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10
Q

What are the three signs of dermatomyositis?

A 
Gorton's sign (hands)
Heliotrope sign (face) 
Shawl sign (neck and back)
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11
Q

Name three other organs polymyositis can affect

A
  • lung
  • oesophagus
  • heart
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12
Q

Name two special tests used to confirm polymyositis

A

Confrontational test - push down on flexed forearm

Isotonic test - 30 sit to stand

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13
Q

What are the investigations carried out for polymyositis?

A

Bloods
Electromyography
Muscle biopsy
MRI

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14
Q

What blood tests should be carried out for polymyositis?

A

Creatine kinase
Inflammatory markers
Electrolytes, Calcium, TSH, PTH
Autoantibodies - ANA and Anti-Jo1

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15
Q

What will electromyography of polymyositis show?

A

Increased fibrillations, abnormal motor potentials and complex repetitive discharges

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16
Q

What is the definitive test for polymyositis?

A

Muscle biopsy - shows perivascular inflammation and muscle necrosis

17
Q

What will an MRI of polymyositis show?

A

Muscle inflammation, oedema, fibrosis and calcification

18
Q

How is polymyositis treated?

A

Corticosteroids and immunosuppressants

19
Q

Describe the epidemiology of polymyalgia rheumatica

A

Usually in over 50 year olds with a higher incidence in northern regions

20
Q

What is polymyalgia rheumatica associated with?

A

Temporal arterities/giant cell arterities

21
Q

Describe the clinical features of polymyalgia rheumatica

A

Ache in shoulder and hip girdle, morning stiffness. Often symmetrical with reduced movement of shoulders neck and hip. Strength is normal.

22
Q

What are the features of granulomatous arterities?

A 
Headache
Scalp tenderness
Jaw Claudication 
Visual loss 
Tender/enlarged/pulseless arteries
23
Q

How is polymyalgia rheumatica diagnosed?

A

Raised ESR/PV/CRP

Temporal artery biopsy and ultrasound

24
Q

How is polymyalgia rheumatica treated?

A

Low dose steroids - prednisolone 15mg/day

Gradually reduce steroids over 18 months - after 2 years symptoms are usually gone

25
Q

What is fibromyalgia?

A

Commonest cause of chronic MSK pain in women 22-50 years old - not associated with inflammation but may begin after emotional or physical trauma

26
Q

Explain the pathogenesis of fibromyalgia

A
  1. Pre-existing factors
  2. Precipitating factors
  3. Pain/Fatigue/Depression
  4. Decreased serotonin and endorphins
    Leads to skin hyperactivity, muscle contraction and reconditioning
27
Q

What are the symptoms of fibromyalgia?

A

Fatigue, pain, twitches, morning stiffness, various central symptoms
Tender points - neck, hips, knees, elbows, scapula

28
Q

What criteria is used to diagnose fibromyalgia?

A

ACR

  • widespread pain and symptoms
  • symptoms have been the same for >3months
  • no other condition explains the pain
29
Q

How is fibromyalgia treated?

A

Education, CBT, complementary medicine, anti-depressants, analgesia, graded exercise programme

MSK (22 decks)

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