Myalgia - Revision history

Danbot: Add verified PubMed references (PMIDs 31590993)

2026-03-22T10:55:40Z

Add verified PubMed references (PMIDs 31590993)

← Revisión anterior		Revisión del 10:55 22 mar 2026
Línea 1:		Línea 1:
	==Background==		==Background==
	*Myalgia refers to muscle pain, which may be localized or diffuse		*Myalgia refers to muscle pain, which may be localized or diffuse<ref>Glaubitz S, et al. Myalgia in myositis and myopathies. Best Pract Res Clin Rheumatol. 2019 Jun;33(3):101433. PMID 31590993</ref>
	*Extremely common complaint — most cases are benign (viral illness, overexertion, medication side effect)		*Extremely common complaint — most cases are benign (viral illness, overexertion, medication side effect)
	*Key EM concern: differentiate benign myalgia from [[rhabdomyolysis]], myositis, and [[necrotizing fasciitis]]		*Key EM concern: differentiate benign myalgia from [[rhabdomyolysis]], myositis, and [[necrotizing fasciitis]]

Danbot: Strip excess bold

2026-03-22T09:37:37Z

Strip excess bold

Danbot: Expanded with EM-focused content: rhabdomyolysis red flags, localized vs diffuse DDx, CK-based evaluation, management, disposition

2026-03-20T23:52:59Z

Expanded with EM-focused content: rhabdomyolysis red flags, localized vs diffuse DDx, CK-based evaluation, management, disposition

@@ Línea 1: / Línea 1: @@
 ==Background==
-==Clinical Features==
+===Physical Exam===
-*Muscle pain/ache
+*Localized tenderness, swelling, induration
 ==Differential Diagnosis==
 {{Myalgia DDX}}
 ==Evaluation==
-*Myalgias can be divided into diffuse (systemic) myalgias vs. localized myalgias.
+===When Workup is Needed===
-*Muscle pain can come from [[rhabdomyolysis]], [[myositis]], or myopathy.
+*Diffuse myalgias with red flags (dark urine, weakness, fever)
 ==Management==
 ==Disposition==
 ==See Also==
+*[[Rhabdomyolysis]]
 ==External Links==
 ==References==
@@ Línea 28: / Línea 119: @@
 [[Category:Rheumatology]]
-[[category:Symptoms]]
+[[Category:Symptoms]]

ClaireLewis: /* Clinical Features */

2019-10-22T13:45:35Z

Clinical Features

← Revisión anterior		Revisión del 13:45 22 oct 2019
Línea 3:		Línea 3:

	==Clinical Features==		==Clinical Features==
			*Muscle pain/ache

	==Differential Diagnosis==		==Differential Diagnosis==

ClaireLewis at 23:49, 17 October 2019

2019-10-17T23:49:27Z

← Revisión anterior		Revisión del 23:49 17 oct 2019
Línea 9:		Línea 9:

	==Evaluation==		==Evaluation==
	*Myalgias can be divided into diffuse (systemic) myalgias vs. ~~Localized~~ myalgias.		*Myalgias can be divided into diffuse (systemic) myalgias vs. localized myalgias.
	*Muscle pain can come from ~~Rhabdomyolysis~~, ~~Myositis~~, or ~~Myopathy~~.		*Muscle pain can come from [[rhabdomyolysis]], [[myositis]], or myopathy.

	==Management==		==Management==
Línea 28:		Línea 28:

	[[Category:Rheumatology]]		[[Category:Rheumatology]]
			[[category:Symptoms]]

Rossdonaldson1: /* Differential Diagnosis */

2019-04-02T00:50:44Z

Differential Diagnosis

@@ Línea 6: / Línea 6: @@
 ==Differential Diagnosis==
-*Infection:
+{{Myalgia DDX}}
 ==Evaluation==

Rossdonaldson1 at 00:49, 2 April 2019

2019-04-02T00:49:44Z

← Revisión anterior		Revisión del 00:49 2 abr 2019
Línea 93:		Línea 93:
	==References==		==References==
	<references/>		<references/>

			[[Category:Rheumatology]]

Rossdonaldson1: /* Differential Diagnosis */

2019-04-02T00:47:39Z

Differential Diagnosis

← Revisión anterior		Revisión del 00:47 2 abr 2019
Línea 39:		Línea 39:
	*[[Rhabdomyolysis]]		*[[Rhabdomyolysis]]
	*[[Myositis]] (e.g, polymyositis, dermatomyositis)		*[[Myositis]] (e.g, polymyositis, dermatomyositis)
			**[[Myositis (peds)]]
	*[[Systemic lupus erythematosus]]		*[[Systemic lupus erythematosus]]
	*[Rheumatoid arthritis]]		*[[Rheumatoid arthritis]]
	*Inclusion body myositis		*Inclusion body myositis
	*[[Sarcoidosis]]		*[[Sarcoidosis]]

Rossdonaldson1: /* Differential Diagnosis */

2019-04-02T00:46:55Z

Differential Diagnosis

← Revisión anterior		Revisión del 00:46 2 abr 2019
Línea 14:		Línea 14:
	**Bisphosphonates		**Bisphosphonates
	**Corticosteroids		**Corticosteroids
	**Ciprofloxacin		**[[Ciprofloxacin]]
	**Clofibrate		**Clofibrate
	**Colchicine		**Colchicine
Línea 37:		Línea 37:
	**[[Hyperparathyroidism]]		**[[Hyperparathyroidism]]
	*[[Polymyalgia rheumatica]]		*[[Polymyalgia rheumatica]]
	*[Rhabdomyolysis]]		*[[Rhabdomyolysis]]
	*[[Myositis]] (e.g, polymyositis, dermatomyositis)		*[[Myositis]] (e.g, polymyositis, dermatomyositis)
	*[[Systemic lupus erythematosus]]		*[[Systemic lupus erythematosus]]
Línea 50:		Línea 50:
	*[[Lyme disease]]		*[[Lyme disease]]
	*Ehlers Danlos (Hypermobility syndrome)		*Ehlers Danlos (Hypermobility syndrome)
	*[HIV]] myopathy		*[[HIV]] myopathy
	*[[Hypophosphatemia]]		*[[Hypophosphatemia]]
	*[[Hypokalemia]]		*[[Hypokalemia]]
Línea 58:		Línea 58:
	*[[Seizure]]		*[[Seizure]]
	*Severe volume contraction		*Severe volume contraction
	*[Alcoholism]]		*[[Alcoholism]]
	*Muscular dystrophy		*Muscular dystrophy
	**Duchenne		**Duchenne

Rossdonaldson1: /* Differential Diagnosis */

2019-04-02T00:46:22Z

Differential Diagnosis

← Revisión anterior		Revisión del 00:46 2 abr 2019
Línea 7:		Línea 7:
	==Differential Diagnosis==		==Differential Diagnosis==
	*Infection:		*Infection:
	**Viral infection (e.g. [[Influenza ~~virus~~]])		**Viral infection (e.g. [[Influenza]])
	**Bacterial infection		**Bacterial infection
	**Spirochete infection (E.g. [[Dengue fever]]; [[Trichinella ~~infection~~]])		**Spirochete infection (E.g. [[Dengue fever]]; [[Trichinella]])
	*Drugs:		*Drugs:
	**Statins		**[[Statins]]
	**Bisphosphonates		**Bisphosphonates
	**~~corticosteroids~~		**Corticosteroids
	**~~ciprofloxacin~~		**Ciprofloxacin
	**~~clofibrate~~		**Clofibrate
	**~~colchicine~~		**Colchicine
	**~~chloroquine~~		**Chloroquine
	**~~emetine~~		**Emetine
	**~~aminocaproic~~ acid		**Aminocaproic acid
	**~~zidovudine~~		**Zidovudine
	**~~bretylium~~		**Bretylium
	**~~penicillamine~~		**Penicillamine
	**~~drugs~~ causing hypokalemia		**Drugs causing [[hypokalemia]]
	*Metabolic disorders:		*Metabolic disorders:
	**Vitamin D deficiency;		**[[Vitamin D deficiency]]
	**Mitochondrial myopathy;		**Mitochondrial myopathy
	**Scurvy;		**[[Scurvy]]
	**Osteomalacia		**Osteomalacia
	*Fibromyalgia		*Fibromyalgia
	*Endocrine:		*Endocrine:
	**~~hypothyroidism;~~		**[[Hypothyroidism]]
	**~~hyperthyroidism;~~		**[[Hyperthyroidism]]
	**Cushing’s syndrome;		**[[Cushing’s syndrome]]
	**Adrenal insufficiency;		**[[Adrenal insufficiency]]
	**Hyperparathyroidism		**[[Hyperparathyroidism]]
	*Polymyalgia rheumatica		*[[Polymyalgia rheumatica]]
	*Rhabdomyolysis ~~(and anything that can cause rhabdomyolysis)~~		*[Rhabdomyolysis]]
	*Myositis (~~muscle inflammation):~~ e.g, polymyositis, dermatomyositis		*[[Myositis]] (e.g, polymyositis, dermatomyositis)
	*Systemic lupus erythematosus ~~(SLE)~~		*[[Systemic lupus erythematosus]]
	*Rheumatoid arthritis		*[Rheumatoid arthritis]]
	*Inclusion body myositis		*Inclusion body myositis
	*Sarcoidosis		*[[Sarcoidosis]]
	*Scleroderma		*[[Scleroderma]]
	*Sjögren’s syndrome		*[[Sjögren’s syndrome]]
	*Psychiatric (e.g. somatic manifestations of depression)		*Psychiatric (e.g. somatic manifestations of depression)
	*Domestic abuse; Crush injury		*[[Domestic abuse]]
	*Lyme disease		*[[Crush injury]]
			*[[Lyme disease]]
	*Ehlers Danlos (Hypermobility syndrome)		*Ehlers Danlos (Hypermobility syndrome)
	*HIV myopathy		*[HIV]] myopathy
	*Hypophosphatemia		*[[Hypophosphatemia]]
	*Hypokalemia		*[[Hypokalemia]]
	*Hypothermia		*[[Hypothermia]]
	*Prolonged immobility~~, eg, after a drug overdose.~~		*Prolonged immobility
	*Strenuous exercise (overuse) or heat stroke		*Strenuous exercise (overuse) or [[heat stroke]]
	*Seizure		*[[Seizure]]
	*Severe volume contraction		*Severe volume contraction
	*Alcoholism		*[Alcoholism]]
	*Muscular dystrophy~~, eg,~~ Duchenne, Becker, limb-girdle, facioscapulohumeral ~~(FSH);~~ Myotonic dystrophy; Myotonia congenita		*Muscular dystrophy
	*Compartment syndrome; Muscle infarction		**Duchenne
			**Becker
			**limb-girdle
			**facioscapulohumeral
			**Myotonic dystrophy
			**Myotonia congenita
			*[[Compartment syndrome]]; Muscle infarction
	*Neuropathic		*Neuropathic
	*Chronic fatigue syndrome		*Chronic fatigue syndrome
	*Vasculitis		*Vasculitis
	*Sarcocystosis		*[[Sarcocystosis]]
	*Spinal stenosis		*[[Spinal stenosis]]
	*Diabetic lumbosacral plexopathy		*Diabetic lumbosacral plexopathy

← Revisión anterior		Revisión del 09:37 22 mar 2026
Línea 2:		Línea 2:
	*Myalgia refers to muscle pain, which may be localized or diffuse		*Myalgia refers to muscle pain, which may be localized or diffuse
	*Extremely common complaint — most cases are benign (viral illness, overexertion, medication side effect)		*Extremely common complaint — most cases are benign (viral illness, overexertion, medication side effect)
	*Key EM concern: differentiate benign myalgia from ~~'''~~[[rhabdomyolysis]]~~'''~~, ~~'''~~myositis~~'''~~, and ~~'''~~[[necrotizing fasciitis]]~~'''~~		*Key EM concern: differentiate benign myalgia from [[rhabdomyolysis]], myositis, and [[necrotizing fasciitis]]
	*Diffuse myalgias may indicate systemic disease (viral infection, autoimmune, endocrine, toxicologic)		*Diffuse myalgias may indicate systemic disease (viral infection, autoimmune, endocrine, toxicologic)
	*Statin-induced myopathy is one of the most common medication-related causes		*Statin-induced myopathy is one of the most common medication-related causes
Línea 46:		Línea 46:

	===Diffuse===		===Diffuse===
	*~~'''~~Viral illness~~'''~~ (influenza, COVID-19, EBV, dengue, enterovirus — most common cause)		*Viral illness (influenza, COVID-19, EBV, dengue, enterovirus — most common cause)
	*~~'''~~[[Rhabdomyolysis]]~~'''~~ (exertional, traumatic, drug-induced)		*[[Rhabdomyolysis]] (exertional, traumatic, drug-induced)
	*'''Medication-induced''': statins, fibrates, ACE inhibitors, colchicine		*'''Medication-induced''': statins, fibrates, ACE inhibitors, colchicine
	*~~'''~~Inflammatory myopathy~~'''~~: dermatomyositis, polymyositis, inclusion body myositis		*Inflammatory myopathy: dermatomyositis, polymyositis, inclusion body myositis
	*~~'''~~Endocrine~~'''~~: [[hypothyroidism]], [[adrenal insufficiency]], vitamin D deficiency		*Endocrine: [[hypothyroidism]], [[adrenal insufficiency]], vitamin D deficiency
	*~~'''~~Electrolyte abnormality~~'''~~: [[hypokalemia]], [[hypocalcemia]], [[hypomagnesemia]], [[hypophosphatemia]]		*Electrolyte abnormality: [[hypokalemia]], [[hypocalcemia]], [[hypomagnesemia]], [[hypophosphatemia]]
	*~~'''~~Autoimmune/rheumatologic~~'''~~: [[SLE]], [[polymyalgia rheumatica]], [[vasculitis]]		*Autoimmune/rheumatologic: [[SLE]], [[polymyalgia rheumatica]], [[vasculitis]]
	*~~'''~~Toxicologic~~'''~~: [[alcohol]], [[cocaine]], [[serotonin syndrome]], [[neuroleptic malignant syndrome]]		*Toxicologic: [[alcohol]], [[cocaine]], [[serotonin syndrome]], [[neuroleptic malignant syndrome]]
	*Fibromyalgia (diagnosis of exclusion)		*Fibromyalgia (diagnosis of exclusion)

Línea 63:		Línea 63:

	===Laboratory===		===Laboratory===
	*~~'''~~[[CK]] (creatine kinase)~~'''~~: key test — markedly elevated in rhabdomyolysis (>5x normal), moderately elevated in myositis		*[[CK]] (creatine kinase): key test — markedly elevated in rhabdomyolysis (>5x normal), moderately elevated in myositis
	*~~'''~~[[BMP]]~~'''~~: renal function (rhabdomyolysis can cause AKI), potassium, calcium, phosphate		*[[BMP]]: renal function (rhabdomyolysis can cause AKI), potassium, calcium, phosphate
	*~~'''~~[[Urinalysis]]~~'''~~: positive for blood on dipstick with no RBCs on microscopy = myoglobinuria		*[[Urinalysis]]: positive for blood on dipstick with no RBCs on microscopy = myoglobinuria
	*[[CBC]]: infection, leukemia		*[[CBC]]: infection, leukemia
	*[[TSH]] if chronic or unexplained myalgias		*[[TSH]] if chronic or unexplained myalgias