21 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 ... #Inflammatory ... #myopathies #Dermatomyositis ... Fibromyalgia #Hypothyroid ... #Drug-induced myopathies
Statin Induced Muscle Toxicity - Summary

Clinical Presentation:
 • Elevations of serum creatine kinase with proximal myalgia
myopathy, rhabdomyolysis ... , toxic myopathy ... , hypothyroid-induced ... myopathies such ... Statin-induced myopathy
Weakness - Differential Diagnosis Framework

Approach To Weakness:
 • Non-neuromuscular disorder (Cardiac, pulmonary etc)
 • CNS ->
proximal weakness Myopathy ... mediated necrotizing myopathy ... Endocrinopathies: Hypothyroid ... • Metabolic myopathies ... certain drug-induced myopathies
Idiopathic Inflammatory Myopathies - 
Dermatomyositis (DM), Immune-Mediated Necrotizing Myopathy (IMNM), Antisynthetase Syndrome (ASS), Inclusion Body Myositis
Idiopathic Inflammatory ... Myopathies - ... Immune-Mediated Necrotizing Myopathy ... #Myopathies #Idiopathic ... #Myopathy #Comparison
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
Myopathies (IIM's ... myopathies (IIM's ... myopathy that occurs ... myopathy affecting ... #Myopathies #IIMs
Myositis and Myopathies
Polymyositis 
 • Progressive, symmetric muscle weakness 
 • Elevated CK, +Anti-Jo, +Anti-Mi2
Dermatomyositis
Myositis and Myopathies ... load Drug-induced myopathy ... 5-15% of lupus myopathy ... BostonChiefs #Myositis #Myopathies ... #myopathy #differential
Creatine Kinase - Causes of Elevated CK Levels
Acute CK Elevation (Pain > Weakness):
 • RHABDOMYOLYSIS
Critical Illness Myopathy ... - Metabolic Myopathies ... toxoplasmosis - Inflammatory ... myopathy: dermatomyositis ... polymyositis, necrotizing myopathy
Hypothyroid Myopathy
Very common (up to 80% ) in patients with hypothyroidism
Pathophysiology:
 • T4 deficiency leads to
Hypothyroid Myopathy ... Symmetric, proximal myopathy ... Rhabdomyolysis (rare) #Hypothyroid ... #Myopathy #pathophysiology
Abdominal Distention - Differential Diagnostic Algorithm
Ascites
Bowel Dilatation
Other Causes
Mechanical Obstruction
 • Adhesions 60%
 • Volvulus 3%
 •
Megacolon • Inflammatory ... • Ischemic Myopathic ... Scleroderma • Familial Myopathy