muscle weakness

Question 1

causes

Answer 1

dermatomyositis
polymyosistis
polymyalgia rheumatica
hypothyroid

Question 2

history in dermatomyositis

Answer 2

• rash - blue purple with periorbital oedema, flat rash (face and upper trunk), raised purple-red scaly patches over extensor surfaces
• systemic upset with fever, arthralgia, malaise and weight loss
• can resemble scleroderma with raynauds and dysphagia
• weak thoracic muscles and ILD
• GI ulcer and infection

Question 3

examination in dematomyositis

Answer 3

• ulcerative vasculitis and calcinosrs of subcutaneous tissue may occur
• photosensitive rash
• dilated capillary loops at the fingernail base
• muscle weakness is proximal
• muscle pain and tenderness

Question 4

investigations in dematomyositis

Answer 4

elevated CK
elevated ALT, LDH and aldolase
autoantibodies (ANA, anti-Mi-2, anti-Jo-1 antibodies)
EMG
muscle biopsy (Can be diagnostic)

Question 5

history in polymyositis

Answer 5

inflammatory myopathy
weakness in the proximal muscles
difficulty getting up from chair, climbing steps
spared distal muscles 
pharyngeal weakness causes dysphagia
no rash

Question 6

examination in polymyositis

Answer 6

muscle weakness
muscular atrophy but preservation of tender reflexes, flexor plantar response and normal sesnsation
muscles tender on palpitation and nodular grainy feel

Question 7

investigations in polymyositis

Answer 7

CK raised
anti Jo1 antibodies
raised SGOT and SGPT and LDH

Question 8

diagnosis of polymyositis

Answer 8

electromyohgraphy and confirmed by biopsy