Polymyositis - Revision history

Kennybroccoli: /* Management */

2022-12-15T08:35:33Z

Management

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 **[[Methotrexate]] as second line for poor response to corticosteroids
 **Other agents with less evidence: IVIG, TNF Inhibitors
 ==Disposition==

2022-12-15T08:32:53Z

Disposition

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	==Disposition==		==Disposition==
	*Rheumatology or neurology consultation either in ED or as outpatient depending on severity of symptoms		*Rheumatology or neurology consultation either in ED or as outpatient depending on severity of symptoms
	*Very strongly associated with malignancy (~30%), especially:<ref>Hill CL et al. Frequency of specific cancer types in dermatomyositis and polymyositis: a population-based study. Lancet. 2001 Jan 13;357(9250):96-100.</ref>
	**Ovarian
	**Lung
	**Pancreatic
	**Stomach
	**Colorectal
	**Lymphoma
	**Bladder

	==See Also==		==See Also==

2022-12-15T08:32:12Z

Evaluation

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	==Evaluation==		==Evaluation==

			===Workup===
	*CBC		*CBC
	*ESR		*ESR
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	**Anti-Jo-1		**Anti-Jo-1
	**Myositis antibody panel		**Myositis antibody panel

			===Diagnosis===
			*Typically requires muscle biopsy

	==Management==		==Management==

2022-12-15T08:30:01Z

Evaluation

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	*ESR		*ESR
	*CRP		*CRP
	*CK		*CK: Most sensitive muscle enzyme
	*[[Urinalysis]]		*[[Urinalysis]]
	*Consider:		*Consider:
			**LDH
			**AST/ALT
			**Aldolase
	**RF		**RF
	**ANA		**ANA

2022-12-15T08:27:58Z

Background

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	==Background==		==Background==
	*Idiopathic inflammatory myopathy causing symmetric proximal muscle weakness, elevated CK,and characteristic EMG findings		*Idiopathic inflammatory myopathy causing symmetric proximal muscle weakness, elevated CK, and characteristic EMG findings

	==Clinical Features==		==Clinical Features==

2022-08-20T05:22:37Z

Evaluation

2019-10-03T04:27:31Z

← Revisión anterior		Revisión del 04:27 3 oct 2019
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	==Background==		==Background==
	Idiopathic inflammatory myopathy causing symmetric proximal muscle weakness, elevated CK,and characteristic EMG findings		*Idiopathic inflammatory myopathy causing symmetric proximal muscle weakness, elevated CK,and characteristic EMG findings

	==Clinical Features==		==Clinical Features==
	*Symmetrical proximal muscle weakness with insidious onset		*Symmetrical proximal muscle [[weakness]] with insidious onset
	*Generally painless (though 30% have myalgia)		*Generally painless (though 30% have [[myalgia]])
	*Difficulty with kneeling, climbing stairs, combing hair, or rising from a seated position		*Difficulty with kneeling, climbing stairs, combing hair, or rising from a seated position
	*Weak neck extensors causing difficulty of holding head up		*Weak neck extensors causing difficulty of holding head up

2019-04-02T00:59:58Z

Differential Diagnosis

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	==Differential Diagnosis==		==Differential Diagnosis==
	*[[Hypokalemia]]		{{Myalgia DDX}}
	*[[Hypophosphatemia]]
	*[[Thyroid disorder]] (hypothyroidism or hyperthyroidism)
	*Myopathies
	*Inclusion body myositis
	*Drug Induced myopathies (EtOH, antimalarials, colchicine, antifungals)

	{{Weakness DDX}}		{{Weakness DDX}}

2017-07-13T06:42:01Z

2016-10-19T15:00:53Z

Differential Diagnosis

← Revisión anterior		Revisión del 15:00 19 oct 2016
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	==Differential Diagnosis==		==Differential Diagnosis==
	*Hypokalemia		*[[Hypokalemia]]
	*Hypophosphatemia		*[[Hypophosphatemia]]
	*Thyroid disorder (hypothyroidism or hyperthyroidism)		*[[Thyroid disorder]] (hypothyroidism or hyperthyroidism)
	*Myopathies		*Myopathies
	*Inclusion body myositis		*Inclusion body myositis