Polymyositis

Question 1

What is Polymyositis?

Answer 1

Polymyositisis a connective tissue diseases characterised by inflammation of muscles.

It is part of a group of Idiopathic inflammatory myopathies . Which are chronic, autoimmune conditions affecting primarily the proximal muscles. The most common types are dermatomyositis and polymyositis

Question 2

What will you find in a history taking of Polymyostiti?

Answer 2

Symptoms:
Inflammatory myopathy with onset over weeks or months and steady progression.
Diffuse weakness in the proximal muscles - difficulty rising from a low chair, climbing steps, lifting objects and combing hair
Distal muscles are spared - fine motor movements of the hand unnafected
Pharyngeal weakness causes dysphagia.

Risk Factors:
Between 30 and 60 years of age
Female

Question 3

What will you find on examination of Polymyositis?

Answer 3

End of the bed:
Muscles may be tender on palpation and may have a nodular grainy feel.

Hands:
Proximal muscle weakness

Neck:
Forced flexion of the neck is weak and there may be difficulty just holding the head up.

Legs:
Proximal muscle weakness

Question 4

What investigations will you order in Polymyositis?

Answer 4

Bloods:
Creatinine Kinase - Raised

Special Tests:
Electromyography and muscle biopsy is diagnostic

Question 5

What is the treatment of Polymyositis?

Answer 5

Lifestyle:
Encourage exercise to maintain strength

Medical:
Medical:
Steroids - Systemic or topical
Second line - azathioprine