13 results
Myositis and Myopathies
#ESR #CK #Differential diagnosis of myopathy 
#Inflammatory #myopathies	#Dermatomyositis	
#muscle weakness
#Polymyositis	
#Inclusion body myositis
#Polymyalgia rheumatica	
#Fibromyalgia	
#Hypothyroid myopathy	
#Muscle stiffness
#Drug-induced
Myositis and Myopathies ... #ESR #CK #Differential ... #Inflammatory ... #myopathies #Dermatomyositis ... Fibromyalgia #Hypothyroid
Statin Induced Muscle Toxicity - Summary

Clinical Presentation:
 • Elevations of serum creatine kinase with proximal myalgia
, hypothyroid-induced ... Statins → Inflammatory ... myopathies such ... : Inflammatory statin ... Diagnosis: • CK
Idiopathic Inflammatory Myopathies - 
Dermatomyositis (DM), Immune-Mediated Necrotizing Myopathy (IMNM), Antisynthetase Syndrome (ASS), Inclusion Body Myositis
Idiopathic Inflammatory ... Myopathies - ... TerrierBen #Inflammatory ... #Myopathies #Idiopathic ... #Myopathy #Comparison
Myositis and Myopathies
Polymyositis 
 • Progressive, symmetric muscle weakness 
 • Elevated CK, +Anti-Jo, +Anti-Mi2
Dermatomyositis
Myositis and Myopathies ... weakness • Elevated CK ... rash • Elevated CK ... mildly elevated CK ... BostonChiefs #Myositis #Myopathies
Creatine Kinase - Causes of Elevated CK Levels
Acute CK Elevation (Pain > Weakness):
 • RHABDOMYOLYSIS
Causes of Elevated CK ... Levels Acute CK ... - Metabolic Myopathies ... toxoplasmosis - Inflammatory ... Kinase #Elevated #CK
Inflammatory Myopathies
Dermatomyositis
 • Onset: Subacute
 • Pattern: Proximal
 • CK: Up to 50X ULN
 • Autoantibodies:
Inflammatory Myopathies ... : Proximal • CK ... : Proximal • CK ... BrighamChiefs #Inflammatory ... #Myopathies #differential
Causes of Proximal Muscle Weakness That May Mimic Inflammatory Myopathy
 • Central or peripheral neurologic disease
That May Mimic Inflammatory ... Myopathy • Central ... • Metabolic myopathies ... Mitochondrial myopathy ... MuscleWeakness #Myopathy
Idiopathic Inflammatory Myopathies (IIM's)

RASH + MUSCLE WEAKNESS → Consider idiopathic inflammatory myopathies (IIM's)

 • Overlap Myositis
Idiopathic Inflammatory ... Myopathies (IIM's ... myopathies (IIM's ... myopathy that occurs ... #Myopathies #IIMs
Weakness - Differential Diagnosis Framework

Approach To Weakness:
 • Non-neuromuscular disorder (Cardiac, pulmonary etc)
 • CNS ->
spinal cord • Inflammatory ... : • Inflammatory ... Endocrinopathies: Hypothyroid ... • Metabolic myopathies ... certain drug-induced myopathies
Hypothyroid Myopathy
Very common (up to 80% ) in patients with hypothyroidism
Pathophysiology:
 • T4 deficiency leads to
Hypothyroid Myopathy ... Asymptomatic CK ... Symmetric, proximal myopathy ... Rhabdomyolysis (rare) #Hypothyroid ... #Myopathy #pathophysiology