Myalgia Flashcards
What areas does PMR affect?
Must be bilateral
Shoulder or pelvic Girdle pain (radiation - present as elbow pain in many)
And stiffness over 45mins Duration more than 2 weeks Worse with movement Proximal muscles Affects sleep Fever fatigue wt.loss
No muscle weakness
Diagnosis of PMR?
2 key features (stiffness, and pain)
Exclude others
Positive response to steroids
Do cpr and esr
Exclude GCA (causes problems)
Exclude cancer or infection
Which drugs cause myalgia or myocitis?
Statins (raised CK)
Quinidine (PMR-like syndrome)
How do you treat PMR?
High dose steroids (then ween - 2/3years)
Provide blue steroid card/ immunosuppression advise
Risk of osteoporosis
Symptoms of GCA?
Diplopia/ visual loss
Jaw Claudicztion
Temporal artery tenderness
Raised ESR
Treat with prednisolone
Complications of GCA?
Blindness (1/5)
Aortic aneurysm
Stroke / MI
Polymyocytis features?
Symmetrical proximal muscle weakness
Resp muscle weakness (dyspnoea)
Arthalgia and arthritis
Droopy head (weak neck)
Polymyocytis ix?
Ck (raised)
Alt and ldh
Anti-jo 1(anti-syntithase )
EMG / MRI - muscle inflammation and biopsy
Skin changes in dermatomyositis?
Gottron papules
Heliotrope rash (eyes)
Photosensitive rash
Mechanics hands (peel)
Complications of polymyocytis
Interstitial lung disease
Dysphagia/ resp failure
Malignancy (10%)
Polymyocytis treatment
1) high dose steroids
2) IV IG rescue therapy
Long term - steroid sparing agents
Fibromyalgia Criteria:
Tender points >11 /18 (digital force of 4kg)
> 3 month history wide spread pain
Bilateral, above and below waist
Fibromyaligia treatment
Education Graded exercise programmes CBT Analgesia : tramadol, amitrypaline, Heated pools help
What is osteomalacia
Soft bones
What’s the treatment for PMR?
15mg prednisolone
