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Flashcards in Muscle Diseases Deck (22)
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1

What is polymyositis?

an idiopathic, inflammatory myopathy that causes symmetrical, proximal muscle weakness

2

What is dermatomyositis?

clinically similar to polymyositis but with cutaneous manifestations

3

which groups are most commonly affected by polymyositis?

women; 45-60years

4

What is the pathogenic mechanism behind polymyositis?

T cell mediated process whereby macrophages and T cells surround and destroy healthy non-necrotic muscle tissue against unidentified muscle antigens

5

Autoantibodies in polymyositis

Specific: Anti-Jo1, Anti-SRP Non-specific: ANA and anti-cytoplasmic

6

Presentation of polymyositis

symmetrical proximal muscle weakness of upper and lower limbs, insidious onset often noticed when tasks become difficult i.e. climbing stairs. Dysphagia secondary to oropharyngeal and oesophageal involvement occurs in 33% and is a poor prognostic indicator

7

Occurs in 15-30% of polymyositis patients esp. those positive with Anti-Jo1

interstitial lung disease

8

Which investigations should be ordered for polymyositis? (6)

Inflammatory markers, CK, Autoantibodies, MRI, EMG, Muscle biopsy

9

Results of CK and inflammatory markers in polymyositis

raised inflammatory markers and CK very raised, often 10 fold

10

MRI results for polymyositis

oedema, inflammation and scarring of muscle

11

EMG results in polymyositis

abnormal in 90%

12

Management of polymyositis

prednisolone (40mg), immunosuppression (methotrexate or azathioprine)

13

Rashes associated with dermatomyositis (3)

Shawl, V-shaped rash over chest and shoulders; Gottrons papules (over the knuckles); Heliotrope purple rash around eyes

14

Polymyositis/Dermatomyositis have an associated risk of malignancy - TRUE/FALSE

TRUE - around 25% of patients will develop cancer within the first 5 years of diagnosis

15

Common cancers associated with polymyositis/dermatomyositis (6)

breast, ovarian, lung, colon, oesophageal, bladder

16

What is fibromyalgia?

unexplained condition that causes widespread muscle fatigue and pain

17

most common group affected by fibromyalgia?

young - middle age women (but can affect anyone)

18

Which autoimmune conditions are associated with fibromyalgia?

RA (25%), SLE (50%)

19

Presentation of fibromyalgia

persistent >3 months widespread pain, fatigue with unrefreshing sleep, cognitive difficulties, multiple other unexplained symptoms, anxiety and/or depression, IBS, migraine

20

Diagnosis of fibromyalgia

diagnosis on clinical basis after ruling out conditions which present similarly

21

Management of fibromyalgia

self-management techniques, atypical analgesia, graded exercise and activity pacing, CBT

22

atypical analgesia which might be used in fibromyalgia

amitryptilline, gabapentin, pregabalin