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Flashcards in Myalgia Deck (15):
1

What areas does PMR affect?

Must be bilateral
Shoulder or pelvic Girdle pain (radiation - present as elbow pain in many)

And stiffness over 45mins
Duration more than 2 weeks
Worse with movement
Proximal muscles
Affects sleep
Fever fatigue wt.loss

No muscle weakness

2

Diagnosis of PMR?

2 key features (stiffness, and pain)
Exclude others

Positive response to steroids

Do cpr and esr
Exclude GCA (causes problems)
Exclude cancer or infection

3

Which drugs cause myalgia or myocitis?

Statins (raised CK)
Quinidine (PMR-like syndrome)

4

How do you treat PMR?

High dose steroids (then ween - 2/3years)
Provide blue steroid card/ immunosuppression advise
Risk of osteoporosis

5

Symptoms of GCA?

Diplopia/ visual loss
Jaw Claudicztion
Temporal artery tenderness
Raised ESR

Treat with prednisolone

6

Complications of GCA?

Blindness (1/5)
Aortic aneurysm
Stroke / MI

7

Polymyocytis features?

Symmetrical proximal muscle weakness
Resp muscle weakness (dyspnoea)
Arthalgia and arthritis
Droopy head (weak neck)

8

Polymyocytis ix?

Ck (raised)
Alt and ldh

Anti-jo 1(anti-syntithase )
EMG / MRI - muscle inflammation and biopsy

9

Skin changes in dermatomyositis?

Gottron papules
Heliotrope rash (eyes)
Photosensitive rash
Mechanics hands (peel)

10

Complications of polymyocytis

Interstitial lung disease
Dysphagia/ resp failure
Malignancy (10%)

11

Polymyocytis treatment

1) high dose steroids
2) IV IG rescue therapy

Long term - steroid sparing agents

12

Fibromyalgia Criteria:

Tender points >11 /18 (digital force of 4kg)
> 3 month history wide spread pain
Bilateral, above and below waist

13

Fibromyaligia treatment

Education
Graded exercise programmes
CBT
Analgesia : tramadol, amitrypaline,
Heated pools help

14

What is osteomalacia

Soft bones

15

What's the treatment for PMR?

15mg prednisolone