muscle diseases Flashcards
what is polymyositis and dermatomyositis
autoimmune diseases affecting skeletal muscle, dermatomyositis the same but with cutaneous involvement
who normally suffers from polymyositis and dermatomyositis
females 40-50
what immune cells cause damage in polymyositis and dermatomyositis
CD8 and macrophages illicit cytotoxic response in healthy cells
what symptoms are present in polymyositis and dermatomyositis
predominately muscle weakness, interstitial SOB and cough, dysphagia
describe the muscle weakness in polymyositis and dermatomyositis
insidious onset, symmetrical, proximal muscles, mild myalgia, struggles to carry things eg baby, shopping
what cancers are people with polymyositis and dermatomyositis at an increased risk of
ovarian, breast, stomach, lung
what symptoms are present in dermatomyositis and NOT polymyositis
Gotton’s sign on hand
what autoantibdoes are present in polymyositis and dermatomyositis
anti-jo-1, ANA
what muscle investigations can be done for polymyositis and dermatomyositis (5)
muscle enzymes eg CK, EMG, muscle biopsy, strength testing, MRI
how do you treat polymyositis and dermatomyositis (mild –> severe)
corticosteroids eg pred, immunosuppression eg azathioprine/ methotrexate, Iv immunoglobin, rituximab
who gets polymyalgia rheumatica
almost always women over 50
what is the defining symptom of polymyalgia rheumatica
ache/ stiffness in shoulder and hip regions with morning stiffness >1 hour
what are additional symptoms of polymyalgia rheumatica
fatigue, weight loss, fever, reduced movement, normal muscle strength
what investigations are done for polymyalgia rheumatica
bloods: PV, CRP, CK which is normal
what treatment is there fro polymyalgia rheumatica
low dose - 15mg steroids for 18 months gradually reduced
what is a common, dangerous association of polymyalgia rheumatica
giant cell/ temporal arteritis
what treatment is given to polymyalgia rheumatica if they have giant cell arteritis
pred 40-60mg - 60mg if visual disturbances
what is fibromyalgia
commonest cause of chronic MSK pain in women aged 20-50 - no actual pathology
what can trigger fibromyalgia
emotional/ physical abuse/ trauma
what is the diagnostic criteria for fibromyalgia
widespread pain at same intensity for 3+ months with no response to pain meds and no significant findings
what are symptoms of fibromyalgia
trouble sleeping, migraines, fatigue, depression/ anxiety, IBS, sensitivity (pain, heat noise), wheelchair bound
what treatment is available for fibromyalgia
behavioural/ physio therapy, antidepressants, analgesia, gabapentin
