26 results
Autoimmune Myositis
Necrotizing myopathy is associated with higher CK levels, greater level of muscle weakness, less systemic
, holster sign, ... anti-synthetase syndrome ... - Classic triad ... at diagnosis). ... #diagnosis #rheumatology
Ramsay Hunt Syndrome - Herpes Zoster Oticus 
Triad:
1. Ipsilateral facial paralysis 
2. Ear pain 
3. Vesicles
Ramsay Hunt Syndrome ... Zoster Oticus Triad ... neuropathy • Myelitis ... HerpesZoster #Oticus #Diagnosis ... #Symptoms #Signs
Myositis Specific Antibodies (MSAs)

Dermatomyositis: MDA5, TIF1y, NXP2, Mi-2, SAE
Anti-Synthetase Syndrome: Jo-1, PL7, PL12, EJ, OJ
Immune Mediated
Myositis Specific ... Anti-Synthetase Syndrome ... MSAs #clinical #diagnosis ... #rheumatology # ... table
Weakness - Differential Diagnosis Framework

Approach To Weakness:
 • Non-neuromuscular disorder (Cardiac, pulmonary etc)
 • CNS ->
- Differential Diagnosis ... • Acute stroke syndromes ... Paraneoplastic syndrome ... Lack of UMN/LMN signs ... #Differential #Diagnosis
Autoantibodies in Rheumatology
 • Lupus (SLE): ANA (anti-nuclear antibody), dsDNA (double-stranded DNA), Anti-Smith, Anti-Ro (SSA) and
Antiphospholipid Antibody Syndrome ... LAC) • Sjogren Syndrome ... Peptide (CCP) • Myositis ... #diagnosis #associations ... #table
Inflammatory Myopathies
Dermatomyositis
 • Onset: Subacute
 • Pattern: Proximal
 • CK: Up to 50X ULN
 • Autoantibodies:
heliotrope, shawl sign ... Necrotizing Autoimmune Myositis ... Inclusion Body Myositis ... #comparison #rheumatology ... #table
Systemic Sclerosis (Scleroderma)
Multi-system autoimmune disease characterized by vasculopathy and progressive fibrosis of skin and internal organs
3
skin thickening Signs ... acro-osteolysis, myositis ... overlap • Vascular ... Scleroderma #SSc #rheumatology ... #diagnosis #signs
Clinical Features of Systemic Lupus (SLE)
General: Fever (50%), Depression, Fatigue (75%), Weight loss (50%)
Eye: Sjögrens (15%)
Skin
Demyelinating syndromes ... Glomerulonephritis Myositis ... erythematosus #signs ... #symptoms #diagnosis ... #rheumatology
Causes of Chronic Dyspnea - Differential Diagnosis Algorithm
Pericardial
 • Effusion
 • Cardiac Tamponade*
 • Constriction
Myocardial
 •
- Differential Diagnosis ... Artery Disease • Stable ... Acute Coronary Syndrome ... Arrhythmia • Atrial ... #Differential #Diagnosis
Idiopathic Inflammatory Myopathies (IIM's)

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

 • Overlap Myositis
• Overlap Myositis ... antisynthetase syndrome ... Inclusion body myositis ... infrequent extra-muscular ... Myopathies #IIMs #diagnosis