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MSK Diseases > Muscle Diseases > Flashcards

Muscle Diseases Flashcards

1
Q

What is Polymyalgia Rheumatica?

A

Common inflammatory condition causing myalgia at the hip and shoulder girdles

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2
Q

What is PR characterised by?

A

Proximal myalgia of the shoulder and hip girdles
morning stiffness > 1 hour
Strong relation to GCA

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3
Q

Who gets PR?

A

Women over 50s

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4
Q

What are the symptoms of PR?

A

Dramatic muscle stiffness (no muscle weakness)

Shoulder and hip pain

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5
Q

Investigations for PR?

A

Raised CRP + PV/ESR

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6
Q

Treatment for PR?

A

15mg Prednisolone reduced over 18 months

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7
Q

What is Giant Cell Arteritis?

A

Commonest form of systemic vasculitis.

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8
Q

Who gets GCA?

A

Older patients

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9
Q

What are the symptoms of GCA?

A

Visual disturbances (diplopia since temporal artery supplies optic nerve, Amaurosis fugax)
Headaches (continuous in occipital or temporal region)
Jaw claudication (maxillary artery ischaemia)
Scalp tenderness
Fatigue
Malaise
Fever

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10
Q

What are the characteristics of GCA?

A

Transmural inflammation of intima, media and adventitia of arteries
patchy infiltration by lymphocytes, macrophages + multinucleated giant cells
Vessel wall thickening –> arterial luminal narrowing –> distal ischaemia

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11
Q

Investigations for GCA?

A

Temporal artery biopsy (mononuclear infiltration/granulomatous inflammation)
Raised ESR, CRP + PV

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12
Q

Treatment for GCA?

A

Prednisolone 40mg (without visual impairment) or 60mg (with visual impairment)

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13
Q

What is Polymyositis?

A

Idiopathic inflammatory myopathy that causes symmetrical muscle weakness.

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14
Q

What are risk factors for Polymyositis?

A

High alcohol consumption + Illicit drug use

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15
Q

Pathogenesis of Polymyositis?

A

CD8+ T cells and macrophages surround healthy muscle tissue and initiate a cytotoxic response.

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16
Q

Who gets Polymyositis?

A

Females over 20, usually between 45-60

17
Q

Symptoms of Polymyositis?

A 
Symmetrical proximal muscle weakness in the upper + lower limbs
Myalgia (sometimes)
Insidious onset
Dysphagia
ILD
Gradual onset 
Fever
Weight loss
Raynaud's
Polyarthritis
SOB
Cough
18
Q

Investigations for Polymyositis?

A 
Raised inflammatory markers
Raised serum CK
Anti-Jo-1 and Anti-SRP
MRI (muscle inflammation, oedema, fibrosis, calcification)
Electromyography
Muscle biopsy
19
Q

Treatment of Polymyositis?

A

40mg Prednisolone combined with immunosuppressive drugs (methotrexate/azathioprine)

MSK Diseases (1 decks)

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