Myositis

Question 1

idiopathic inflammatory myopathies

Answer 1

rare autoimmune diseases usually presenting with progressive, symmetrical, proximal muscle weakness

Question 2

idiopathic inflammatory myopathies are characterised by

Answer 2

elevated CK, abnormalities on MRI and evidence of an irritative pattern on EMG

Question 3

definitive diagnostic test for idiopathies inflammatory myopathies

Answer 3

muscle biopsy

Question 4

dermatomyositis clinical features

Answer 4

any age
F > M
proximal
CK+++ x50

Question 5

dermatomyositis biopsy

Answer 5

perimysial and perivascular inflammation

Question 6

dermatomyositis associations

Answer 6

malignancy
ILD
connective tissue disorders
calcinosis in children

Question 7

polymyositis clinical features

Answer 7

adults
F > M
no rash
proximal
CK+++ x50

Question 8

polymyositis biopsy

Answer 8

inflammation
surrounding and invading muscle fibres

Question 9

polymyositis associations

Answer 9

interstitial lung disease
autoimmune ddisorders
cancer

Question 10

inclusion body myositis (IBM) clinical features

Answer 10

elderly
M > F
no rash
finger flexors, knee extensors
dysphagia
CK+ x20

Question 11

inclusion body myositis biopsy

Answer 11

rimmed vacuoles (inclusion bodies)
inflammation surrounding and invading muscle fibres

Question 12

inclusion body myositis associations

Answer 12

autoimmune disorders
poorly responsive to immunosuppressant therapy

Question 13

necrotising autoimmune myositis clinical features

Answer 13

adult and older
F > M
proximal
CK+ x10

Question 14

necrotising autoimmune myositis biopsy

Answer 14

necrotic muscle fibres with absence of inflammation

Question 15

necrotising autoimmune myositis

Answer 15

malignancy
connective tissue disease
drug induced

Question 16

MRI for myositis

Answer 16

diffuse and patchy test to confirm diagnosis, exclude other conditions and distinguish dermatomyositis from polymyositis

Question 17

anti synthetase antibodies

Answer 17

associated with a subgroup of polymyositis with high incidence of interstitial lung disease, mechanics hands and raynauds

Question 18

anti signal recognition particle

Answer 18

strong association with aggressive necrotising myositis and poor response to steroid treatment

Question 19

anti Mi-2 antibody

Answer 19

strong association with acute polymyositis and dermatomyositis with good response to treatment wth immunosuppressants