Polymyositis/Dermatomyositis + Fibromyalgia Flashcards
What is polymyositis/dermatomyositis?
Inflammation and necrosis of skeletal muscle
Where skin involved = dermatomyositis
What is the RF?
Females
HLA B8/DR3 genetic link
Sx of poly?
Symmetrical wasting of muscles of shoulders + pelvic girdle
Hard to stand from sitting, to squat, put hands on top of head (may involve resp muscles)
Dermato Sx?
+ skin change (Gottron papules - scales on knuckles, heliotrope = purple eyelid)
Diagnosis of poly?
Muscle fibre Biopsy necrosis + DIAGNOSTIC
LDH + CK raised
Anti JO + Anti Mi2 Abs (derma only)
Treatment of poly?
Bed rest + prednisolone (1 month then tapered down dose)
What is fibromyalgia?
MSK equivalent of IBS
Chronic widespread pain (MSK) for 3+ months with all other causes ruled out
RF for fibromyalgia?
Females, Depression, stress, poor, 60+
Sx of Fibromyalgia?
Stressed, depressed, 60+ female, fatigue, sleep disturbance, morning stiffness (esp back and neck) + pain
Dx of fibromyalgia?
No serological markers (ANA, aPL, anti CCP, RF)
No High CRP/ESR
+ pain in 11/18 regions palpated therefore clinically made
Dx of fibromyalgia?
No serological markers (ANA, aPL, anti CCP, RF)
No High CRP/ESR
+ pain in 11/18 regions palpated therefore clinically made
Tx for fibromyalgia?
Educate Px + physiotherapy
Anti depressants for severe neuropathic pain (eg. TCA, Amytripline) + CBT
What is a DDx for fibromyalgia?
Polymyalgia rheumatica (PMR)
What Is PMR?
large cell vasculitis presenting as chronic pain syndrome (affects muscle + joints), females, 50+
Dx of PMR?
high ESR/CRP = DIAGNOSTIC
Temporal biopsy may show GCA + may have anemia of chronic disease - normocytic
