Polymyositis and dermatomyositis differential diagnosis: Difference between revisions

	Polymyositis and dermatomyositis Microchapters
Home
Patient Information
Overview
Historical Perspective
Classification
Pathophysiology
Causes
Differentiating Polymyositis and dermatomyositis from other Diseases
Epidemiology and Demographics
Risk Factors
Screening
Natural History, Complications and Prognosis
Diagnosis
Diagnostic Study of Choice
History and Symptoms
Physical Examination
Laboratory Findings
Electrocardiogram
X-ray
Echocardiography and Ultrasound
CT scan
MRI
Other Imaging Findings
Other Diagnostic Studies
Treatment
Medical Therapy
Surgery
Primary Prevention
Secondary Prevention
Cost-Effectiveness of Therapy
Future or Investigational Therapies
Case Studies
Case #1
Polymyositis and dermatomyositis differential diagnosis On the Web
Most recent articles
Most cited articles
Review articles
CME Programs
Powerpoint slides
Images
American Roentgen Ray Society Images of Polymyositis and dermatomyositis differential diagnosis All Images X-rays Echo & Ultrasound CT Images MRI
Ongoing Trials at Clinical Trials.gov
US National Guidelines Clearinghouse
NICE Guidance
FDA on Polymyositis and dermatomyositis differential diagnosis
CDC on Polymyositis and dermatomyositis differential diagnosis
Polymyositis and dermatomyositis differential diagnosis in the news
Blogs on Polymyositis and dermatomyositis differential diagnosis
Directions to Hospitals Treating Psoriasis
Risk calculators and risk factors for Polymyositis and dermatomyositis differential diagnosis

VisualWikitext

Revision as of 22:44, 19 April 2018

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1];

Overview

Differentiating

Organ system	Disease	Symptoms												History	Physical Examination	Diagnosis
Organ system	Disease	Age of onset	Muscle weakness	Fever	Myalgia	Contractures	Gait abnormality	Neuropathy	Atrophy	Stiffness	Myoglobinuria	Other features	Laboratory Findings	History	Physical Examination	Creatine Kinase	Muscle Biopsy	Electromyogram
Inflammatory/ Rheumatologic	Dermatomyositis^[1]	40s−50s Can affect children	Proximal	+	+	−	−	−	−	+	−	Rash Dyspnea Weight loss Cough	Viral infections Cancer	Heliotrope rash on face and hands Telangiectasia Erythema Mechanic's hands Gottron's sign ( violaceous scaly eruption )	↑↑ ESR ↑↑ CRP	↑↑	Perimysial mononuclear infiltrate	Myopathic
	Polymyositis^[2]	> 18 years	Proximal	+	+	−	−	−	−	+	−	Similar to dermatomyositis without mucous and skin involvement	N/A	N/A	↑↑ ESR ↑↑ CRP	↑↑	Endomysial mononuclear infiltrate Patchy necrosis	Myopathic
	Inclusion body myositis^[3]	50s	Proximal & distal	−	−	−	−	−	−	−	−	Dysphagia Asymmetric weakness	Retrovirus (most common)	N/A	Antibodies to cytoplasmic 5'−nucleotidase	↑↑	Inflammatory cells Invading muscle cells Vacuolar degeneration Inclusions or plaques	Neurogenic
	Fibromyalgia^[4]	40−50s	Generalized	−	−	−	−	+	−	−	−	Anxiety or depression features Fatigue Sleep disturbance Numbness Muscle spasms	History of depression	Tenderness in the soft tissue anatomical location	Normal	Normal	Normal	Normal
	Polymyalgia Rheumatica^[5]	50s	Diffuse	+	+	−	−	−	−	+	−	Weight loss	History of joints stiffness, worse in the morning	Restricted shoulder motion	↑↑ ESR ↑↑ CRP	Normal	Normal	Normal

References

↑ Dalakas MC (1991). "Polymyositis, dermatomyositis and inclusion-body myositis". N Engl J Med. 325 (21): 1487–98. doi:10.1056/NEJM199111213252107. PMID 1658649.
↑ Dalakas MC (1991). "Polymyositis, dermatomyositis and inclusion-body myositis". N Engl J Med. 325 (21): 1487–98. doi:10.1056/NEJM199111213252107. PMID 1658649.
↑ Dalakas MC (1991). "Polymyositis, dermatomyositis and inclusion-body myositis". N Engl J Med. 325 (21): 1487–98. doi:10.1056/NEJM199111213252107. PMID 1658649.
↑ Ohara N, Katada S, Yamada T, Mezaki N, Suzuki H, Suzuki A, Hanyu O, Yoneoka Y, Kawachi I, Shimohata T, Kakita A, Nishizawa M, Sone H (2016). "Fibromyalgia in a Patient with Cushing's Disease Accompanied by Central Hypothyroidism". Intern. Med. 55 (21): 3185–3190. doi:10.2169/internalmedicine.55.5926. PMC 5140872. PMID 27803417.
↑ Myklebust G, Gran JT (1996). "A prospective study of 287 patients with polymyalgia rheumatica and temporal arteritis: clinical and laboratory manifestations at onset of disease and at the time of diagnosis". Br J Rheumatol. 35 (11): 1161–8. PMID 8948307.

Template:WH Template:WS

[pmid1658649-1] Dalakas MC (1991). "Polymyositis, dermatomyositis and inclusion-body myositis". N Engl J Med. 325 (21): 1487–98. doi:10.1056/NEJM199111213252107. PMID 1658649.

[pmid16586492-2] Dalakas MC (1991). "Polymyositis, dermatomyositis and inclusion-body myositis". N Engl J Med. 325 (21): 1487–98. doi:10.1056/NEJM199111213252107. PMID 1658649.

[pmid16586493-3] Dalakas MC (1991). "Polymyositis, dermatomyositis and inclusion-body myositis". N Engl J Med. 325 (21): 1487–98. doi:10.1056/NEJM199111213252107. PMID 1658649.

[pmid27803417-4] Ohara N, Katada S, Yamada T, Mezaki N, Suzuki H, Suzuki A, Hanyu O, Yoneoka Y, Kawachi I, Shimohata T, Kakita A, Nishizawa M, Sone H (2016). "Fibromyalgia in a Patient with Cushing's Disease Accompanied by Central Hypothyroidism". Intern. Med. 55 (21): 3185–3190. doi:10.2169/internalmedicine.55.5926. PMC 5140872. PMID 27803417.

[pmid8948307-5] Myklebust G, Gran JT (1996). "A prospective study of 287 patients with polymyalgia rheumatica and temporal arteritis: clinical and laboratory manifestations at onset of disease and at the time of diagnosis". Br J Rheumatol. 35 (11): 1161–8. PMID 8948307.

[1]

[2]

[3]

[4]

[5]

@@ Line 7: / Line 7: @@
 == Differentiating  ==
+[[Dexamethasone suppression test|<nowiki/>]]
 {|
 ! rowspan="2" style="background:#4479BA; color: #FFFFFF;" align="center" + |Organ system
@@ Line 27: / Line 28: @@
 ! style="background:#4479BA; color: #FFFFFF;" align="center" + |Myoglobinuria
 ! style="background:#4479BA; color: #FFFFFF;" align="center" + |Other features
-! style="background:#4479BA; color: #FFFFFF;" align="center" + |Laboratory Findings
-! style="background:#4479BA; color: #FFFFFF;" align="center" + |Creatine Kinase
-! style="background:#4479BA; color: #FFFFFF;" align="center" + |Muscle Biopsy
-! style="background:#4479BA; color: #FFFFFF;" align="center" + |Electromyogram
-|-
-! rowspan="3" style="background:#DCDCDC;" align="center" + |Medication−induced
-! style="background:#DCDCDC;" align="center" + |[[Corticosteroids]]<ref name="pmid24083177">{{cite journal |vauthors=Gupta A, Gupta Y |title=Glucocorticoid-induced myopathy: Pathophysiology, diagnosis, and treatment |journal=Indian J Endocrinol Metab |volume=17 |issue=5 |pages=913–6 |date=September 2013 |pmid=24083177 |pmc=3784879 |doi=10.4103/2230-8210.117215 |url=}}</ref>
-| style="background:#F5F5F5;" align="center" + |Variable
-| style="background:#F5F5F5;" align="center" + |Proximal
-| style="background:#F5F5F5;" align="center" + |−
-| style="background:#F5F5F5;" align="center" + |<nowiki>+</nowiki>
-| style="background:#F5F5F5;" align="center" + | −
-| style="background:#F5F5F5;" align="center" + |−
-| style="background:#F5F5F5;" align="center" + | −
-| style="background:#F5F5F5;" align="center" + |<nowiki>+</nowiki>
-| style="background:#F5F5F5;" align="center" + |−
-| style="background:#F5F5F5;" align="center" + |−
-| style="background:#F5F5F5;" align="left" + |
-* [[Central obesity]]
-* Excessive [[sweating]]
-* [[Insomnia]]
-* Reduced [[libido]]
-* [[Amenorrhoea|Amenorrhea]]
-* [[Infertility]]
-* Psychological disturbances
-| style="background:#F5F5F5;" align="left" + |
-*Positive h/o medications
-| style="background:#F5F5F5;" align="left" + |
-* Facial and sphincter [[Muscle|muscles]] are usually spared
-| style="background:#F5F5F5;" align="left" + |
-* Positive [[ACTH stimulation test]]
-* 24-hour urine [[cortisol]]
-* Low dose [[dexamethasone suppression test]]
-| style="background:#F5F5F5;" align="left" + |
-* Normal
-| style="background:#F5F5F5;" align="left" + |
-* Normal
-| style="background:#F5F5F5;" align="left" + |
-* Normal
-|-
-! style="background:#DCDCDC;" align="center" + |[[Statins]]<ref name="pmid22001973">{{cite journal |vauthors=Tomaszewski M, Stępień KM, Tomaszewska J, Czuczwar SJ |title=Statin-induced myopathies |journal=Pharmacol Rep |volume=63 |issue=4 |pages=859–66 |date=2011 |pmid=22001973 |doi= |url=}}</ref>
-| style="background:#F5F5F5;" align="center" + |60+
-| style="background:#F5F5F5;" align="center" + |Proximal
-| style="background:#F5F5F5;" align="center" + |−
-| style="background:#F5F5F5;" align="center" + |<nowiki>+</nowiki>
-| style="background:#F5F5F5;" align="center" + | −
-| style="background:#F5F5F5;" align="center" + |−
-| style="background:#F5F5F5;" align="center" + |−
-| style="background:#F5F5F5;" align="center" + |−
-| style="background:#F5F5F5;" align="center" + |−
-| style="background:#F5F5F5;" align="center" + |−/+([[Rhabdomyolysis]])
-| style="background:#F5F5F5;" align="left" + |
-* N/A
-| style="background:#F5F5F5;" align="left" + |
-*Positive h/o medications
-*H/o other medication use
-| style="background:#F5F5F5;" align="left" + |
-* [[Tenderness]]
-* Muscle aches
-| style="background:#F5F5F5;" align="left" + |
-* '''↑↑''' Liver enzymes
-| style="background:#F5F5F5;" align="left" + |
-* '''↑↑'''
-| style="background:#F5F5F5;" align="left" + |
-* [[Necrosis]]
-* Degeneration, and regeneration of fibers
-* Phagocytic infiltration
-| style="background:#F5F5F5;" align="left" + |
-* Normal
-|-
-! style="background:#DCDCDC;" align="center" + |[[Alcohol]]<ref name="pmid11784353">{{cite journal |vauthors=Preedy VR, Adachi J, Ueno Y, Ahmed S, Mantle D, Mullatti N, Rajendram R, Peters TJ |title=Alcoholic skeletal muscle myopathy: definitions, features, contribution of neuropathy, impact and diagnosis |journal=Eur. J. Neurol. |volume=8 |issue=6 |pages=677–87 |date=November 2001 |pmid=11784353 |doi= |url=}}</ref>
-| style="background:#F5F5F5;" align="center" + |Variable
-| style="background:#F5F5F5;" align="center" + |Proximal
-| style="background:#F5F5F5;" align="center" + |−
-| style="background:#F5F5F5;" align="center" + |−
-| style="background:#F5F5F5;" align="center" + |−
-| style="background:#F5F5F5;" align="center" + |<nowiki>+</nowiki>
-| style="background:#F5F5F5;" align="center" + | +/−
-| style="background:#F5F5F5;" align="center" + |−
-| style="background:#F5F5F5;" align="center" + |−
-| style="background:#F5F5F5;" align="center" + |−
-| style="background:#F5F5F5;" align="left" + |
-* [[Swelling]]
-* Tender
-* [[Erythema]] and induration
-| style="background:#F5F5F5;" align="left" + |
-* [[Alcohol]] intoxication
-| style="background:#F5F5F5;" align="left" + |
-* Change in [[mental status]]
-* [[Telangiectasias|Telangiectasia]]
-* [[Peripheral neuropathy]]
-| style="background:#F5F5F5;" align="left" + |
-* Monspecific and are normal in many patients
-| style="background:#F5F5F5;" align="left" + |
-* Normal or '''↑↑'''
-| style="background:#F5F5F5;" align="left" + |
-* Normal
-| style="background:#F5F5F5;" align="left" + |
-* Normal
-|-
-! style="background:#4479BA; color: #FFFFFF;" align="center" + |Organ system
-! style="background:#4479BA; color: #FFFFFF;" align="center" + |Disease
-! style="background:#4479BA; color: #FFFFFF;" align="center" + |Age of onset
-! style="background:#4479BA; color: #FFFFFF;" align="center" + |Muscle weakness
-! style="background:#4479BA; color: #FFFFFF;" align="center" + |Fever
-! style="background:#4479BA; color: #FFFFFF;" align="center" + |Myalgia
-! style="background:#4479BA; color: #FFFFFF;" align="center" + |'''Contractures'''
-! style="background:#4479BA; color: #FFFFFF;" align="center" + |Gait abnormality
-! style="background:#4479BA; color: #FFFFFF;" align="center" + |Neuropathy
-! style="background:#4479BA; color: #FFFFFF;" align="center" + |Atrophy
-! style="background:#4479BA; color: #FFFFFF;" align="center" + |Stiffness
-! style="background:#4479BA; color: #FFFFFF;" align="center" + |Myoglobinuria
-! style="background:#4479BA; color: #FFFFFF;" align="center" + |Other features
-! style="background:#4479BA; color: #FFFFFF;" align="center" + |History
-! style="background:#4479BA; color: #FFFFFF;" align="center" + |Physical
-Examination
-! style="background:#4479BA; color: #FFFFFF;" align="center" + |Laboratory Findings
-! style="background:#4479BA; color: #FFFFFF;" align="center" + |Creatine Kinase
-! style="background:#4479BA; color: #FFFFFF;" align="center" + |Muscle Biopsy
-! style="background:#4479BA; color: #FFFFFF;" align="center" + |Electromyogram
-|-
-! rowspan="6" style="background:#DCDCDC;" align="center" + |Endocrine
-! style="background:#DCDCDC;" align="center" + |[[Cushing's disease]]<ref name="pmid25221399">{{cite journal |vauthors=Sharma V, Borah P, Basumatary LJ, Das M, Goswami M, Kayal AK |title=Myopathies of endocrine disorders: A prospective clinical and biochemical study |journal=Ann Indian Acad Neurol |volume=17 |issue=3 |pages=298–302 |date=July 2014 |pmid=25221399 |pmc=4162016 |doi=10.4103/0972-2327.138505 |url=}}</ref>
-| style="background:#F5F5F5;" align="center" + |25 −45
-| style="background:#F5F5F5;" align="center" + |Proximal
-| style="background:#F5F5F5;" align="center" + |−
-| style="background:#F5F5F5;" align="center" + |−
-| style="background:#F5F5F5;" align="center" + |−
-| style="background:#F5F5F5;" align="center" + |−
-| style="background:#F5F5F5;" align="center" + |−
-| style="background:#F5F5F5;" align="center" + |<nowiki>+</nowiki>
-| style="background:#F5F5F5;" align="center" + |−
-| style="background:#F5F5F5;" align="center" + |−
-| style="background:#F5F5F5;" align="left" + |
-* [[Decreased libido]]
-* [[Obesity]]/[[weight gain]]
-* [[Plethora]]
-* Round face
-* Menstrual changes
-* [[Hirsutism]]
-* [[Hypertension]]
-* [[Ecchymoses]]
-* [[Lethargy]]
-* [[Depression]]
-* Dorsal fat pad
-* Abnormal glucose tolerance
-| style="background:#F5F5F5;" align="left" + |
-* N/A
-| style="background:#F5F5F5;" align="left" + |
-* Facial and sphincter [[muscles]] are usually spared
-* [[Overweight]]
-* Straie
-* [[Moon face]]
-* [[Hypertension|HTN]]
-* [[Hyperpigmentation]]
-| style="background:#F5F5F5;" align="left" + |
-* Positive [[ACTH stimulation test]]
-* 24-hour urine [[cortisol]]
-* Low dose [[Dexamethasone suppression test|dexamethasone <nowiki/>suppression test]]
-| style="background:#F5F5F5;" align="left" + |
-* Normal
-| style="background:#F5F5F5;" align="left" + |
-* Atrophy of type 2 muscle fibers, especially type 2B
-| style="background:#F5F5F5;" align="left" + |Normal
-|-
-! style="background:#DCDCDC;" align="center" + |[[Adrenal insufficiency]]<ref name="pmid30656022">{{cite journal |vauthors=Ruff RL, Weissmann J |title=Endocrine myopathies |journal=Neurol Clin |volume=6 |issue=3 |pages=575–92 |date=August 1988 |pmid=3065602 |doi= |url=}}</ref>
-| style="background:#F5F5F5;" align="center" + |30−50 years
-| style="background:#F5F5F5;" align="center" + |Proximal
-| style="background:#F5F5F5;" align="center" + |−
-| style="background:#F5F5F5;" align="center" + | +
-| style="background:#F5F5F5;" align="center" + | −
-| style="background:#F5F5F5;" align="center" + |−
-| style="background:#F5F5F5;" align="center" + |−
-| style="background:#F5F5F5;" align="center" + |−
-| style="background:#F5F5F5;" align="center" + |<nowiki>+</nowiki>
-| style="background:#F5F5F5;" align="center" + |−
-| style="background:#F5F5F5;" align="left" + |
-* Signs of [[glucocorticoid]], [[mineralocorticoid]], and, [[androgen]] deficiency
-| style="background:#F5F5F5;" align="left" + |
-* Signs of [[postural hypotension]]
-* History of [[tuberculosis]]
-* History of [[malignancy]]
-* History of other [[autoimmune disease]]
-| style="background:#F5F5F5;" align="left" + |
-* [[Hypotension]]
-* [[Hyperpigmentation]]
-* Auricular−cartilage calcification
-* [[Vitiligo]]
-| style="background:#F5F5F5;" align="left" + |
-* [[Electrolyte abnormalities]]
-* [[Hypoglycemia]]
-| style="background:#F5F5F5;" align="left" + |
-* Normal
-| style="background:#F5F5F5;" align="left" + |
-* Normal
-| style="background:#F5F5F5;" align="left" + |
-* Normal
-|-
-! style="background:#DCDCDC;" align="center" + |[[Hyperaldosteronism]] with myopathy<ref name="pmid5037033">{{cite journal |vauthors=Sambrook MA, Heron JR, Aber GM |title=Myopathy in association with primary hyperaldosteronism |journal=J. Neurol. Neurosurg. Psychiatry |volume=35 |issue=2 |pages=202–7 |date=April 1972 |pmid=5037033 |pmc=494037 |doi= |url=}}</ref>
-| style="background:#F5F5F5;" align="center" + |50
-| style="background:#F5F5F5;" align="center" + |Proximal<br>&<br>distal
-| style="background:#F5F5F5;" align="center" + |−
-| style="background:#F5F5F5;" align="center" + |−
-| style="background:#F5F5F5;" align="center" + | −
-| style="background:#F5F5F5;" align="center" + |−
-| style="background:#F5F5F5;" align="center" + |−
-| style="background:#F5F5F5;" align="center" + |−
-| style="background:#F5F5F5;" align="center" + |−
-| style="background:#F5F5F5;" align="center" + |<nowiki>+</nowiki>
-[[Rhabdomyolysis]]
-| style="background:#F5F5F5;" align="left" + |
-* [[Palpitations]]
-* [[Hypertension]]
-| style="background:#F5F5F5;" align="left" + |
-* Episodes of [[Palpation|increased heart beats]]
-| style="background:#F5F5F5;" align="left" + |
-* [[Hyperpigmentation]]
-| style="background:#F5F5F5;" align="left" + |
-* [[Hypokalemia]]
-| style="background:#F5F5F5;" align="left" + |
-* Normal
-| style="background:#F5F5F5;" align="left" + |
-* Normal
-| style="background:#F5F5F5;" align="left" + |
-* Normal
-|-
-! style="background:#DCDCDC;" align="center" + |[[Hyperthyroidism]]<ref name="pmid28746208">{{cite journal |vauthors=Li Q, Liu Y, Zhang Q, Tian H, Li J, Li S |title=Myopathy in hyperthyroidism as a consequence of rapid reduction of thyroid hormone: A case report |journal=Medicine (Baltimore) |volume=96 |issue=30 |pages=e7591 |date=July 2017 |pmid=28746208 |pmc=5627834 |doi=10.1097/MD.0000000000007591 |url=}}</ref>
-| style="background:#F5F5F5;" align="center" + |40
-| style="background:#F5F5F5;" align="center" + |Proximal
-| style="background:#F5F5F5;" align="center" + |−
-| style="background:#F5F5F5;" align="center" + |−
-| style="background:#F5F5F5;" align="center" + | −
-| style="background:#F5F5F5;" align="center" + |−
-| style="background:#F5F5F5;" align="center" + |−
-| style="background:#F5F5F5;" align="center" + |<nowiki>+</nowiki>
-| style="background:#F5F5F5;" align="center" + |<nowiki>+</nowiki>
-| style="background:#F5F5F5;" align="center" + |<nowiki>+</nowiki>
-| style="background:#F5F5F5;" align="left" + |
-* Signs of [[hyperthyroidism]]
-| style="background:#F5F5F5;" align="left" + |
-* H/o of [[weight loss]]
-| style="background:#F5F5F5;" align="left" + |
-* [[Sweating]]
-* [[Tremor]]
-* Neck swelling
-| style="background:#F5F5F5;" align="left" + |
-* Decreased [[TSH]]
-| style="background:#F5F5F5;" align="left" + |
-* '''↑↑'''
-| style="background:#F5F5F5;" align="left" + |
-* Non specific
-| style="background:#F5F5F5;" align="left" + |
-* [[Myotonic]]
-|-
-! style="background:#DCDCDC;" align="center" + |[[Hypothyroidism]]<ref name="pmid6627693">{{cite journal |vauthors=Khaleeli AA, Griffith DG, Edwards RH |title=The clinical presentation of hypothyroid myopathy and its relationship to abnormalities in structure and function of skeletal muscle |journal=Clin. Endocrinol. (Oxf) |volume=19 |issue=3 |pages=365–76 |date=September 1983 |pmid=6627693 |doi= |url=}}</ref>
-| style="background:#F5F5F5;" align="center" + |55
-| style="background:#F5F5F5;" align="center" + |Proximal
-| style="background:#F5F5F5;" align="center" + | −
-| style="background:#F5F5F5;" align="center" + |<nowiki>+</nowiki>
-| style="background:#F5F5F5;" align="center" + | +
-| style="background:#F5F5F5;" align="center" + |−
-| style="background:#F5F5F5;" align="center" + |−
-| style="background:#F5F5F5;" align="center" + |<nowiki>+</nowiki>
-| style="background:#F5F5F5;" align="center" + | +
-| style="background:#F5F5F5;" align="center" + | + [[Rhabdomyolysis MRI|Rhabdomyolysis]]
-| style="background:#F5F5F5;" align="left" + |
-*  Signs of [[hypothyroidism]]
-| style="background:#F5F5F5;" align="left" + |
-* H/o [[weight gain]]
-| style="background:#F5F5F5;" align="left" + |
-* [[Myxedema|Myxoedema]]
-* Muscle pseudohypertrophy
-| style="background:#F5F5F5;" align="left" + |
-* Increased [[TSH]]
-| style="background:#F5F5F5;" align="left" + |
-* '''↑↑'''
-| style="background:#F5F5F5;" align="left" + |
-* Nonspecific
-| style="background:#F5F5F5;" align="left" + |
-* Normal
-|-
-! style="background:#DCDCDC;" align="center" + |Diabetic infraction<ref name="pmid25932331">{{cite journal |vauthors=Horton WB, Taylor JS, Ragland TJ, Subauste AR |title=Diabetic muscle infarction: a systematic review |journal=BMJ Open Diabetes Res Care |volume=3 |issue=1 |pages=e000082 |date=2015 |pmid=25932331 |pmc=4410119 |doi=10.1136/bmjdrc-2015-000082 |url=}}</ref>
-| style="background:#F5F5F5;" align="center" + |45
-| style="background:#F5F5F5;" align="center" + |Proximal
-| style="background:#F5F5F5;" align="center" + | +
-| style="background:#F5F5F5;" align="center" + | +
-| style="background:#F5F5F5;" align="center" + |−
-| style="background:#F5F5F5;" align="center" + |−
-| style="background:#F5F5F5;" align="center" + | +
-| style="background:#F5F5F5;" align="center" + |<nowiki>+</nowiki>
-| style="background:#F5F5F5;" align="center" + |−
-| style="background:#F5F5F5;" align="center" + | −
-| style="background:#F5F5F5;" align="left" + |
-* [[Cramps]]
-* Sudden onset of [[pain]]
-* Anterior thigh [[muscles]] are most commonly involved
-| style="background:#F5F5F5;" align="left" + |
-* H/O long standing [[diabetes]]
-| style="background:#F5F5F5;" align="left" + |
-* [[Swelling]]
-* [[Tenderness]]
-| style="background:#F5F5F5;" align="left" + |
-* Elevated [[ESR]]
-* [[Leukocytosis]]
-| style="background:#F5F5F5;" align="left" + |
-* Normal
-| style="background:#F5F5F5;" align="left" + |
-* [[Necrosis]]
-* [[Edema]]
-| style="background:#F5F5F5;" align="left" + |
-* Normal
-|-
-! style="background:#4479BA; color: #FFFFFF;" align="center" + |Organ system
-! style="background:#4479BA; color: #FFFFFF;" align="center" + |Disease
-! style="background:#4479BA; color: #FFFFFF;" align="center" + |Age of onset
-! style="background:#4479BA; color: #FFFFFF;" align="center" + |Muscle weakness
-! style="background:#4479BA; color: #FFFFFF;" align="center" + |Fever
-! style="background:#4479BA; color: #FFFFFF;" align="center" + |Myalgia
-! style="background:#4479BA; color: #FFFFFF;" align="center" + |'''Contractures'''
-! style="background:#4479BA; color: #FFFFFF;" align="center" + |Gait abnormality
-! style="background:#4479BA; color: #FFFFFF;" align="center" + |Neuropathy
-! style="background:#4479BA; color: #FFFFFF;" align="center" + |Atrophy
-! style="background:#4479BA; color: #FFFFFF;" align="center" + |Stiffness
-! style="background:#4479BA; color: #FFFFFF;" align="center" + |Myoglobinuria
-! style="background:#4479BA; color: #FFFFFF;" align="center" + |Other features
-! style="background:#4479BA; color: #FFFFFF;" align="center" + |History
-! style="background:#4479BA; color: #FFFFFF;" align="center" + |Physical
-Examination
 ! style="background:#4479BA; color: #FFFFFF;" align="center" + |Laboratory Findings
 ! style="background:#4479BA; color: #FFFFFF;" align="center" + |Creatine Kinase
@@ Line 509: / Line 181: @@
 | style="background:#F5F5F5;" align="left" + |
 * Normal
-|-
-! style="background:#4479BA; color: #FFFFFF;" align="center" + |Organ system
-! style="background:#4479BA; color: #FFFFFF;" align="center" + |Disease
-! style="background:#4479BA; color: #FFFFFF;" align="center" + |Age of onset
-! style="background:#4479BA; color: #FFFFFF;" align="center" + |Muscle weakness
-! style="background:#4479BA; color: #FFFFFF;" align="center" + |Fever
-! style="background:#4479BA; color: #FFFFFF;" align="center" + |Myalgia
-! style="background:#4479BA; color: #FFFFFF;" align="center" + |'''Contractures'''
-! style="background:#4479BA; color: #FFFFFF;" align="center" + |Gait abnormality
-! style="background:#4479BA; color: #FFFFFF;" align="center" + |Neuropathy
-! style="background:#4479BA; color: #FFFFFF;" align="center" + |Atrophy
-! style="background:#4479BA; color: #FFFFFF;" align="center" + |Stiffness
-! style="background:#4479BA; color: #FFFFFF;" align="center" + |Myoglobinuria
-! style="background:#4479BA; color: #FFFFFF;" align="center" + |Other features
-! style="background:#4479BA; color: #FFFFFF;" align="center" + |History
-! style="background:#4479BA; color: #FFFFFF;" align="center" + |Physical
-Examination
-! style="background:#4479BA; color: #FFFFFF;" align="center" + |Laboratory Findings
-! style="background:#4479BA; color: #FFFFFF;" align="center" + |Creatine Kinase
-! style="background:#4479BA; color: #FFFFFF;" align="center" + |Muscle Biopsy
-! style="background:#4479BA; color: #FFFFFF;" align="center" + |Electromyogram
-|-
-! rowspan="5" style="background:#DCDCDC;" align="center" + |Genetic
-! style="background:#DCDCDC;" align="center" + |[[Becker's muscular dystrophy|Becker muscular dystrophy]]<ref name="pmid25037084">{{cite journal |vauthors=Flanigan KM |title=Duchenne and Becker muscular dystrophies |journal=Neurol Clin |volume=32 |issue=3 |pages=671–88, viii |date=August 2014 |pmid=25037084 |doi=10.1016/j.ncl.2014.05.002 |url=}}</ref>
-| style="background:#F5F5F5;" align="center" + |<13yrs
-| style="background:#F5F5F5;" align="center" + |Proximal
-| style="background:#F5F5F5;" align="center" + |−
-| style="background:#F5F5F5;" align="center" + |−
-| style="background:#F5F5F5;" align="center" + | +
-| style="background:#F5F5F5;" align="center" + |<nowiki>+</nowiki>
-| style="background:#F5F5F5;" align="center" + |−
-| style="background:#F5F5F5;" align="center" + |<nowiki>+</nowiki>
-| style="background:#F5F5F5;" align="center" + |−
-| style="background:#F5F5F5;" align="center" + |−
-| style="background:#F5F5F5;" align="left" + |
-* Milder form of [[Duchenne muscular dystrophy|Duchenne]]
-| style="background:#F5F5F5;" align="left" + |
-* [[Growth delay]]
-* Age of onset of symptoms is much delayed than [[Duchenne muscular dystrophy|duchenne]]
-| style="background:#F5F5F5;" align="left" + |
-* Positive Grower sign
-| style="background:#F5F5F5;" align="left" + |
-* Decreased amount of [[dystrophin]].
-| style="background:#F5F5F5;" align="left" + |
-* ↑↑
-| rowspan="2" style="background:#F5F5F5;" align="left" + |
-** Muscle fibril degeneration, regeneration
-** Isolated fiber hypertrophy
-** Muscle replacement with fat and connective tissue
-| rowspan="2" style="background:#F5F5F5;" align="left" + |
-* [[Myopathic]]
-|-
-! style="background:#DCDCDC;" align="center" + |[[Duchenne muscular dystrophy]]<ref name="pmid250370842">{{cite journal |vauthors=Flanigan KM |title=Duchenne and Becker muscular dystrophies |journal=Neurol Clin |volume=32 |issue=3 |pages=671–88, viii |date=August 2014 |pmid=25037084 |doi=10.1016/j.ncl.2014.05.002 |url=}}</ref>
-| style="background:#F5F5F5;" align="center" + |<13 yrs
-| style="background:#F5F5F5;" align="center" + | Proximal
-| style="background:#F5F5F5;" align="center" + | −
-| style="background:#F5F5F5;" align="center" + | −
-| style="background:#F5F5F5;" align="center" + | +
-| style="background:#F5F5F5;" align="center" + |<nowiki>+</nowiki>
-| style="background:#F5F5F5;" align="center" + | −
-| style="background:#F5F5F5;" align="center" + |<nowiki>+</nowiki>
-| style="background:#F5F5F5;" align="center" + |−
-| style="background:#F5F5F5;" align="center" + | −
-| style="background:#F5F5F5;" align="left" + |
-* Calf psedohypertrophy
-* [[Cardiomyopathy]]
-* [[Kyphoscoliosis]]
-* [[Cognitive impairment]]
-| style="background:#F5F5F5;" align="left" + |
-* Early onset
-| style="background:#F5F5F5;" align="left" + |
-* Positive Grower sign
-| style="background:#F5F5F5;" align="left" + |
-* Errors in the Xp21 gene.
-* Absence of [[dystrophin]].
-| style="background:#F5F5F5;" align="left" + |
-* '''↑↑'''
-|-
-! style="background:#DCDCDC;" align="center" + |[[Limb-girdle muscular dystrophy|Limb−girdle muscular]] dystrophies<ref name="pmid18769252">{{cite journal |vauthors=Guglieri M, Straub V, Bushby K, Lochmüller H |title=Limb-girdle muscular dystrophies |journal=Curr. Opin. Neurol. |volume=21 |issue=5 |pages=576–84 |date=October 2008 |pmid=18769252 |doi=10.1097/WCO.0b013e32830efdc2 |url=}}</ref>
-| style="background:#F5F5F5;" align="center" + |<15 yrs
-| style="background:#F5F5F5;" align="center" + |Proximal
-| style="background:#F5F5F5;" align="center" + |−
-| style="background:#F5F5F5;" align="center" + |<nowiki>+</nowiki>
-| style="background:#F5F5F5;" align="center" + | +
-| style="background:#F5F5F5;" align="center" + |<nowiki>+</nowiki>
-| style="background:#F5F5F5;" align="center" + |−
-| style="background:#F5F5F5;" align="center" + |<nowiki>+</nowiki>
-| style="background:#F5F5F5;" align="center" + |−
-| style="background:#F5F5F5;" align="center" + |−
-| style="background:#F5F5F5;" align="left" + |
-* Calf hypertrophy
-* Scapular winging
-* [[Cardiomyopathy]]
-* [[Cardiac arrhythmia|Cardiac arrhythmias]]
-* Respiratory muscle weakness
-| style="background:#F5F5F5;" align="left" + |
-* [[Autosomal dominant]]
-* Deterioration of ability to run/walk
-| style="background:#F5F5F5;" align="left" + |
-*[[Muscle weakness]] is generally symmetric
-| style="background:#F5F5F5;" align="left" + |
-* [[LMNA]] gene
-* CAV3 gene
-| style="background:#F5F5F5;" align="left" + |
-* '''↑↑'''
-| style="background:#F5F5F5;" align="left" + |
-* N/A
-| style="background:#F5F5F5;" align="left" + |
-* [[Myopathic]]
-|-
-| style="background:#DCDCDC;" align="center" + |[[Myotonic dystrophy]]<ref name="pmid22995693">{{cite journal |vauthors=Udd B, Krahe R |title=The myotonic dystrophies: molecular, clinical, and therapeutic challenges |journal=Lancet Neurol |volume=11 |issue=10 |pages=891–905 |date=October 2012 |pmid=22995693 |doi=10.1016/S1474-4422(12)70204-1 |url=}}</ref>
-| style="background:#F5F5F5;" align="center" + |<18 years
-| style="background:#F5F5F5;" align="center" + |Proximal<br>&<br>distal
-| style="background:#F5F5F5;" align="center" + |−
-| style="background:#F5F5F5;" align="center" + |−
-| style="background:#F5F5F5;" align="center" + | +
-| style="background:#F5F5F5;" align="center" + |<nowiki>+</nowiki>
-| style="background:#F5F5F5;" align="center" + |−
-| style="background:#F5F5F5;" align="center" + |−
-| style="background:#F5F5F5;" align="center" + | +
-| style="background:#F5F5F5;" align="center" + |−
-| style="background:#F5F5F5;" align="left" + |
-* [[Myotonia]]
-* [[Cataracts]]
-* [[Diabetes mellitus]]
-* Frontal balding
-* Cardiac arrhythmias
-* [[Cholecystitis]]
-* [[Pregnancy]]
-* Eyelid [[ptosis]]
-| style="background:#F5F5F5;" align="left" + |
-* Positive family history
-| style="background:#F5F5F5;" align="left" + |
-* Muscles often contract and are unable to relax
-| style="background:#F5F5F5;" align="left" + |
-* Mutations in the [[DMPK]] gene
-| style="background:#F5F5F5;" align="left" + |
-* N/A
-| style="background:#F5F5F5;" align="left" + |
-* N/A
-| style="background:#F5F5F5;" align="left" + |
-* [[Myopathic]]
-|-
-| style="background:#DCDCDC;" align="center" + |[[Glycogen storage disease]]<ref name="pmid11957192">{{cite journal |vauthors=Kannourakis G |title=Glycogen storage disease |journal=Semin. Hematol. |volume=39 |issue=2 |pages=103–6 |date=April 2002 |pmid=11957192 |doi= |url=}}</ref>
-| style="background:#F5F5F5;" align="center" + |Variable
-| style="background:#F5F5F5;" align="center" + |Proximal
-| style="background:#F5F5F5;" align="center" + |−
-| style="background:#F5F5F5;" align="center" + |−
-| style="background:#F5F5F5;" align="center" + | −
-| style="background:#F5F5F5;" align="center" + |−
-| style="background:#F5F5F5;" align="center" + |−
-| style="background:#F5F5F5;" align="center" + |<nowiki>+</nowiki>
-| style="background:#F5F5F5;" align="center" + |−
-| style="background:#F5F5F5;" align="center" + |−
-| style="background:#F5F5F5;" align="left" + |
-* [[Autosomal recessive|AR]]
-* [[Fatigue|Faituge]]
-* [[Hypoglycemia]]
-| style="background:#F5F5F5;" align="left" + |
-* [[Exercise intolerance]]
-| style="background:#F5F5F5;" align="left" + |
-* [[Hypotonia]]
-* [[Hepatomegaly]]
-| style="background:#F5F5F5;" align="left" + |
-* [[Lactic acidosis]]
-* Elevated liver enzymes
-* [[Ketosis]]
-| style="background:#F5F5F5;" align="left" + |
-* '''↑↑'''
-| style="background:#F5F5F5;" align="left" + |
-* Normal
-| style="background:#F5F5F5;" align="left" + |
-* Normal
-|-
-! style="background:#4479BA; color: #FFFFFF;" align="center" + |Organ system
-! style="background:#4479BA; color: #FFFFFF;" align="center" + |Disease
-! style="background:#4479BA; color: #FFFFFF;" align="center" + |Age of onset
-! style="background:#4479BA; color: #FFFFFF;" align="center" + |Muscle weakness
-! style="background:#4479BA; color: #FFFFFF;" align="center" + |Fever
-! style="background:#4479BA; color: #FFFFFF;" align="center" + |Myalgia
-! style="background:#4479BA; color: #FFFFFF;" align="center" + |'''Contractures'''
-! style="background:#4479BA; color: #FFFFFF;" align="center" + |Gait abnormality
-! style="background:#4479BA; color: #FFFFFF;" align="center" + |Neuropathy
-! style="background:#4479BA; color: #FFFFFF;" align="center" + |Atrophy
-! style="background:#4479BA; color: #FFFFFF;" align="center" + |Stiffness
-! style="background:#4479BA; color: #FFFFFF;" align="center" + |Myoglobinuria
-! style="background:#4479BA; color: #FFFFFF;" align="center" + |Other features
-! style="background:#4479BA; color: #FFFFFF;" align="center" + |History
-! style="background:#4479BA; color: #FFFFFF;" align="center" + |Physical
-Examination
-! style="background:#4479BA; color: #FFFFFF;" align="center" + |Laboratory Findings
-! style="background:#4479BA; color: #FFFFFF;" align="center" + |Creatine Kinase
-! style="background:#4479BA; color: #FFFFFF;" align="center" + |Muscle Biopsy
-! style="background:#4479BA; color: #FFFFFF;" align="center" + |Electromyogram
-|-
-! rowspan="5" style="background:#DCDCDC;" align="center" + |Infectious
-! style="background:#DCDCDC;" align="center" + |[[Lyme disease]]<ref name="pmid2795056">{{cite journal |vauthors=Schoenen J, Sianard-Gainko J, Carpentier M, Reznik M |title=Myositis during Borrelia burgdorferi infection (Lyme disease) |journal=J. Neurol. Neurosurg. Psychiatry |volume=52 |issue=8 |pages=1002–5 |date=August 1989 |pmid=2795056 |pmc=1031843 |doi= |url=}}</ref>
-| style="background:#F5F5F5;" align="center" + |Variable
-| style="background:#F5F5F5;" align="center" + |Proximal
-| style="background:#F5F5F5;" align="center" + | +
-| style="background:#F5F5F5;" align="center" + |<nowiki>+</nowiki>
-| style="background:#F5F5F5;" align="center" + | −
-| style="background:#F5F5F5;" align="center" + | +/−
-| style="background:#F5F5F5;" align="center" + |<nowiki>+</nowiki>
-| style="background:#F5F5F5;" align="center" + |−
-| style="background:#F5F5F5;" align="center" + | −
-| style="background:#F5F5F5;" align="center" + |−
-| style="background:#F5F5F5;" align="left" + |
-* Erythema Migrans
-* Flu−like symptoms
-* [[Lyme arthritis]]
-* [[Neurological]] manifestations
-| style="background:#F5F5F5;" align="left" + |
-* H/o tick bite
-* Hiking trip
-| style="background:#F5F5F5;" align="left" + |
-* Target−like [[lesions]]
-* HSM
-| style="background:#F5F5F5;" align="left" + |
-* Clinical diagnosis
-* +Serology
-| style="background:#F5F5F5;" align="left" + |
-* N/A
-| style="background:#F5F5F5;" align="left" + |
-* N/A
-| style="background:#F5F5F5;" align="left" + |
-* N/A
-|-
-! style="background:#DCDCDC;" align="center" + |[[Influenza]]<ref name="pmid6687269">{{cite journal |vauthors=Bove KE, Hilton PK, Partin J, Farrell MK |title=Morphology of acute myopathy associated with influenza B infection |journal=Pediatr Pathol |volume=1 |issue=1 |pages=51–66 |date=1983 |pmid=6687269 |doi= |url=}}</ref>
-| style="background:#F5F5F5;" align="center" + |Variable
-| style="background:#F5F5F5;" align="center" + |
-| style="background:#F5F5F5;" align="center" + | +
-| style="background:#F5F5F5;" align="center" + |<nowiki>+</nowiki>
-| style="background:#F5F5F5;" align="center" + | −
-| style="background:#F5F5F5;" align="center" + | +
-| style="background:#F5F5F5;" align="center" + |−
-| style="background:#F5F5F5;" align="center" + |−
-| style="background:#F5F5F5;" align="center" + |−
-| style="background:#F5F5F5;" align="center" + |<nowiki>+</nowiki>
-| style="background:#F5F5F5;" align="left" + |
-* [[Fever]]
-* [[Malaise]]
-* [[Rhinorrhea]]
-* [[Muscle pain]] worse with movement
-| style="background:#F5F5F5;" align="left" + |
-*Cold weather
-*H/o Ill contacts
-| style="background:#F5F5F5;" align="left" + |
-* Muscle weakness, tenderness, and swelling.
-| style="background:#F5F5F5;" align="left" + |
-* '''↑↑''' Liver enzymes
-* Positive PCR
-| style="background:#F5F5F5;" align="left" + |
-* '''↑↑'''
-| style="background:#F5F5F5;" align="left" + |
-* N/A
-| style="background:#F5F5F5;" align="left" + |
-* N/A
-|-
-! style="background:#DCDCDC;" align="center" + |[[Polio]]<ref name="pmid15933355">{{cite journal |vauthors=Howard RS |title=Poliomyelitis and the postpolio syndrome |journal=BMJ |volume=330 |issue=7503 |pages=1314–8 |date=June 2005 |pmid=15933355 |pmc=558211 |doi=10.1136/bmj.330.7503.1314 |url=}}</ref>
-| style="background:#F5F5F5;" align="center" + |<5 yrs
-| style="background:#F5F5F5;" align="center" + |Proximal
-| style="background:#F5F5F5;" align="center" + | −
-| style="background:#F5F5F5;" align="center" + |−
-| style="background:#F5F5F5;" align="center" + | −
-| style="background:#F5F5F5;" align="center" + |<nowiki>+</nowiki>
-| style="background:#F5F5F5;" align="center" + |<nowiki>+</nowiki>
-| style="background:#F5F5F5;" align="center" + |<nowiki>+</nowiki>
-| style="background:#F5F5F5;" align="center" + |−
-| style="background:#F5F5F5;" align="center" + |−
-| style="background:#F5F5F5;" align="left" + |
-* Asymmetrical [[paralysis]]
-* [[Muscle atrophy]]
-* [[Tremors]]
-* [[Skeletal]] deformities
-| style="background:#F5F5F5;" align="left" + |
-* History of skipped immunization.
-| style="background:#F5F5F5;" align="left" + |
-* Normal
-* [[Meningeal signs]]
-* Asymmetrical flaccid paralysis
-* Pharyngeal paralysis
-| style="background:#F5F5F5;" align="left" + |
-* Isolation from [[pharyngeal]]<nowiki/>secretions, CSF
-* Positive serology
-| style="background:#F5F5F5;" align="left" + |
-* N/A
-| style="background:#F5F5F5;" align="left" + |
-* N/A
-| style="background:#F5F5F5;" align="left" + |
-* Neurological pattern
-|-
-! style="background:#DCDCDC;" align="center" + |[[Syphilis]]<ref name="pmid17235095">{{cite journal |vauthors=French P |title=Syphilis |journal=BMJ |volume=334 |issue=7585 |pages=143–7 |date=January 2007 |pmid=17235095 |pmc=1779891 |doi=10.1136/bmj.39085.518148.BE |url=}}</ref>
-| style="background:#F5F5F5;" align="center" + |Variable
-| style="background:#F5F5F5;" align="center" + |Negative
-| style="background:#F5F5F5;" align="center" + |−
-| style="background:#F5F5F5;" align="center" + |−
-| style="background:#F5F5F5;" align="center" + | −
-| style="background:#F5F5F5;" align="center" + |<nowiki>+</nowiki>
-| style="background:#F5F5F5;" align="center" + |<nowiki>+</nowiki>
-| style="background:#F5F5F5;" align="center" + |−
-| style="background:#F5F5F5;" align="center" + |−
-| style="background:#F5F5F5;" align="center" + |−
-| style="background:#F5F5F5;" align="left" + |
-* [[Chancre]]
-* [[Lymphadenopathy]]
-* Condylomata lata
-* [[Neurosyphilis|Neuro syphilis]]
-* Cardiovascular syphilis
-| style="background:#F5F5F5;" align="left" + |
-* History of risk factors (MSM, unprotected sex, multiple sex partners)
-| style="background:#F5F5F5;" align="left" + |
-* Non−tender [[chancre]] in primary syphilis.
-* Followed by [[rash]]
-* Generalized [[lymphadenopathy]] in secondary syphilis
-| style="background:#F5F5F5;" align="left" + |
-* Darkfield examinations
-* VDRL
-* RPR
-* [[FTA-ABS|FTA−ABS]]
-| style="background:#F5F5F5;" align="left" + |
-* N/A
-| style="background:#F5F5F5;" align="left" + |
-* N/A
-| style="background:#F5F5F5;" align="left" + |
-* N/A
-|-
-! style="background:#DCDCDC;" align="center" + |[[Pyomyositis]]<ref name="pmid15380499">{{cite journal |vauthors=Crum NF |title=Bacterial pyomyositis in the United States |journal=Am. J. Med. |volume=117 |issue=6 |pages=420–8 |date=September 2004 |pmid=15380499 |doi=10.1016/j.amjmed.2004.03.031 |url=}}</ref>
-| style="background:#F5F5F5;" align="center" + |Variable
-| style="background:#F5F5F5;" align="center" + |Proximal<br>&<br>Distal
-| style="background:#F5F5F5;" align="center" + |<nowiki>+</nowiki>
-| style="background:#F5F5F5;" align="center" + |<nowiki>+</nowiki>
-| style="background:#F5F5F5;" align="center" + | −
-| style="background:#F5F5F5;" align="center" + |−
-| style="background:#F5F5F5;" align="center" + |−
-| style="background:#F5F5F5;" align="center" + |−
-| style="background:#F5F5F5;" align="center" + |<nowiki>+</nowiki>
-| style="background:#F5F5F5;" align="center" + |−
-| style="background:#F5F5F5;" align="left" + |
-* [[Fever]]
-* [[Malaise]]
-* [[Psoas abscess]]
-| style="background:#F5F5F5;" align="left" + |
-* [[Immunocompromised]]
-| style="background:#F5F5F5;" align="left" + |
-** Muscles are painful, swollen, tender, and indurated.
-** Depending on the site of involvement, it may mimic appendicitis (psoas muscle), septic arthritis of the hip (iliacus muscle), or epidural abscess (piriformis muscle).
-| style="background:#F5F5F5;" align="left" + |
-* Leukocytosis
-* Elevated ESR
-| style="background:#F5F5F5;" align="left" + |
-* N/A
-| style="background:#F5F5F5;" align="left" + |
-* N/A
-| style="background:#F5F5F5;" align="left" + |
-* N/A
-|-
-! style="background:#4479BA; color: #FFFFFF;" align="center" + |Organ system
-! style="background:#4479BA; color: #FFFFFF;" align="center" + |Disease
-! style="background:#4479BA; color: #FFFFFF;" align="center" + |Age of onset
-! style="background:#4479BA; color: #FFFFFF;" align="center" + |Muscle weakness
-! style="background:#4479BA; color: #FFFFFF;" align="center" + |Fever
-! style="background:#4479BA; color: #FFFFFF;" align="center" + |Myalgia
-! style="background:#4479BA; color: #FFFFFF;" align="center" + |'''Contractures'''
-! style="background:#4479BA; color: #FFFFFF;" align="center" + |Gait abnormality
-! style="background:#4479BA; color: #FFFFFF;" align="center" + |Neuropathy
-! style="background:#4479BA; color: #FFFFFF;" align="center" + |Atrophy
-! style="background:#4479BA; color: #FFFFFF;" align="center" + |Stiffness
-! style="background:#4479BA; color: #FFFFFF;" align="center" + |Myoglobinuria
-! style="background:#4479BA; color: #FFFFFF;" align="center" + |Other features
-! style="background:#4479BA; color: #FFFFFF;" align="center" + |History
-! style="background:#4479BA; color: #FFFFFF;" align="center" + |Physical
-Examination
-! style="background:#4479BA; color: #FFFFFF;" align="center" + |Laboratory Findings
-! style="background:#4479BA; color: #FFFFFF;" align="center" + |Creatine Kinase
-! style="background:#4479BA; color: #FFFFFF;" align="center" + |Muscle Biopsy
-! style="background:#4479BA; color: #FFFFFF;" align="center" + |Electromyogram
-|-
-! rowspan="4" style="background:#DCDCDC;" align="center" + |Neurologic
-! style="background:#DCDCDC;" align="center" + |[[Amyotrophic lateral sclerosis|ALS]]<ref name="pmid26629397">{{cite journal |vauthors=Zarei S, Carr K, Reiley L, Diaz K, Guerra O, Altamirano PF, Pagani W, Lodin D, Orozco G, Chinea A |title=A comprehensive review of amyotrophic lateral sclerosis |journal=Surg Neurol Int |volume=6 |issue= |pages=171 |date=2015 |pmid=26629397 |pmc=4653353 |doi=10.4103/2152-7806.169561 |url=}}</ref>
-| style="background:#F5F5F5;" align="center" + |>35
-| style="background:#F5F5F5;" align="center" + |Proximal<br>&<br>Distal
-* Distal
-| style="background:#F5F5F5;" align="center" + |−
-| style="background:#F5F5F5;" align="center" + |−
-| style="background:#F5F5F5;" align="center" + | −
-| style="background:#F5F5F5;" align="center" + |−
-| style="background:#F5F5F5;" align="center" + |<nowiki>+</nowiki>
-| style="background:#F5F5F5;" align="center" + |<nowiki>+</nowiki>
-| style="background:#F5F5F5;" align="center" + |<nowiki>+</nowiki>
-| style="background:#F5F5F5;" align="center" + |−
-| style="background:#F5F5F5;" align="left" + |
-* [[Dysphagia]]
-* [[Spasticity]]
-* [[Hyperreflexia]]
-* [[Babinski's sign|Babinski's]] +
-| style="background:#F5F5F5;" align="left" + |
-* N/A
-| style="background:#F5F5F5;" align="left" + |
-* Both [[Upper motor neurons|upper]] and [[lower motor neuron]] signs
-| style="background:#F5F5F5;" align="left" + |
-* Clinical diagnosis
-| style="background:#F5F5F5;" align="left" + |
-* Normal
-| style="background:#F5F5F5;" align="left" + |
-* Nonspecific findings of chronic denervation with reinnervation
-| style="background:#F5F5F5;" align="left" + |
-* Neuropathic
-|-
-! style="background:#DCDCDC;" align="center" + |[[Stroke]]<ref name="pmid20412000">{{cite journal |vauthors=Baldwin K, Orr S, Briand M, Piazza C, Veydt A, McCoy S |title=Acute ischemic stroke update |journal=Pharmacotherapy |volume=30 |issue=5 |pages=493–514 |date=May 2010 |pmid=20412000 |doi=10.1592/phco.30.5.493 |url=}}</ref>
-| style="background:#F5F5F5;" align="center" + |>65
-| style="background:#F5F5F5;" align="center" + |Proximal<br>&<br>distal
-| style="background:#F5F5F5;" align="center" + |−
-| style="background:#F5F5F5;" align="center" + |−
-| style="background:#F5F5F5;" align="center" + |−
-| style="background:#F5F5F5;" align="center" + |<nowiki>+</nowiki>
-| style="background:#F5F5F5;" align="center" + |<nowiki>+</nowiki>
-| style="background:#F5F5F5;" align="center" + |<nowiki>+</nowiki>
-| style="background:#F5F5F5;" align="center" + |−
-| style="background:#F5F5F5;" align="center" + |−
-| style="background:#F5F5F5;" align="left" + |
-* [[Dysphagia]]
-* Unilateral/Bilateral weakness
-| style="background:#F5F5F5;" align="left" + |
-* H/o [[Hypertension|HTN]], [[dyslipidaemia]] [[Diabetes mellitus|DM]]
-| style="background:#F5F5F5;" align="left" + |
-* Weakness of the involved arm
-| style="background:#F5F5F5;" align="left" + |
-*Head CT
-| style="background:#F5F5F5;" align="left" + |
-* Normal
-| style="background:#F5F5F5;" align="left" + |
-* Normal
-| style="background:#F5F5F5;" align="left" + |
-* Neuropathic
-|-
-! style="background:#DCDCDC;" align="center" + |[[GBS]]<ref name="pmid23628447">{{cite journal |vauthors=van Doorn PA |title=Diagnosis, treatment and prognosis of Guillain-Barré syndrome (GBS) |journal=Presse Med |volume=42 |issue=6 Pt 2 |pages=e193–201 |date=June 2013 |pmid=23628447 |doi=10.1016/j.lpm.2013.02.328 |url=}}</ref>
-| style="background:#F5F5F5;" align="center" + |18  −350
-| style="background:#F5F5F5;" align="center" + |Proximal
-| style="background:#F5F5F5;" align="center" + |−
-| style="background:#F5F5F5;" align="center" + |−
-| style="background:#F5F5F5;" align="center" + | −
-| style="background:#F5F5F5;" align="center" + |<nowiki>+</nowiki>
-| style="background:#F5F5F5;" align="center" + |−
-| style="background:#F5F5F5;" align="center" + |−
-| style="background:#F5F5F5;" align="center" + |<nowiki>+</nowiki>
-| style="background:#F5F5F5;" align="center" + |−
-| style="background:#F5F5F5;" align="left" + |
-* [[Ascending paralysis]]
-| style="background:#F5F5F5;" align="left" + |
-* Precedes a [[Gastrointestinal diseases|gastrointestinal disease]]
-| style="background:#F5F5F5;" align="left" + |
-* Weakness of lower extremities followed by upper extremities
-| style="background:#F5F5F5;" align="left" + |
-* Cytologic albumin ratio
-| style="background:#F5F5F5;" align="left" + |
-* Normal
-| style="background:#F5F5F5;" align="left" + |
-* Normal
-| style="background:#F5F5F5;" align="left" + |
-* Neuropathic
-|-
-! style="background:#DCDCDC;" align="center" + |[[Multiple sclerosis|Multiple Sclerosis]]<ref name="pmid22605909">{{cite journal |vauthors=Goldenberg MM |title=Multiple sclerosis review |journal=P T |volume=37 |issue=3 |pages=175–84 |date=March 2012 |pmid=22605909 |pmc=3351877 |doi= |url=}}</ref>
-| style="background:#F5F5F5;" align="center" + |30's
-| style="background:#F5F5F5;" align="center" + |Proximal<br>&<br>distal
-| style="background:#F5F5F5;" align="center" + |−
-| style="background:#F5F5F5;" align="center" + |−
-| style="background:#F5F5F5;" align="center" + | −
-| style="background:#F5F5F5;" align="center" + |<nowiki>+</nowiki>
-| style="background:#F5F5F5;" align="center" + |<nowiki>+</nowiki>
-| style="background:#F5F5F5;" align="center" + |−
-| style="background:#F5F5F5;" align="center" + |−
-| style="background:#F5F5F5;" align="center" + |−
-| style="background:#F5F5F5;" align="left" + |
-* Ocular findings
-* [[Urinary incontinence]]
-* Problems with [[Speech and language pathology|speech]] or [[swallowing]]
-| style="background:#F5F5F5;" align="left" + |
-* Attacks or exacerbation
-| style="background:#F5F5F5;" align="left" + |
-** Localized weakness
-** Focal sensory disturbances
-** Hyper reactive reflexes
-** Increased tone or stiffness
-| style="background:#F5F5F5;" align="left" + |
-* Head CT ologo−clonal bands
-| style="background:#F5F5F5;" align="left" + |
-* Normal
-| style="background:#F5F5F5;" align="left" + |
-* N/A
-| style="background:#F5F5F5;" align="left" + |
-* Neuropathic
-|-
-! style="background:#4479BA; color: #FFFFFF;" align="center" + |Organ system
-! style="background:#4479BA; color: #FFFFFF;" align="center" + |Disease
-! style="background:#4479BA; color: #FFFFFF;" align="center" + |Age of onset
-! style="background:#4479BA; color: #FFFFFF;" align="center" + |Muscle weakness
-! style="background:#4479BA; color: #FFFFFF;" align="center" + |Fever
-! style="background:#4479BA; color: #FFFFFF;" align="center" + |Myalgia
-! style="background:#4479BA; color: #FFFFFF;" align="center" + |'''Contractures'''
-! style="background:#4479BA; color: #FFFFFF;" align="center" + |Gait abnormality
-! style="background:#4479BA; color: #FFFFFF;" align="center" + |Neuropathy
-! style="background:#4479BA; color: #FFFFFF;" align="center" + |Atrophy
-! style="background:#4479BA; color: #FFFFFF;" align="center" + |Stiffness
-! style="background:#4479BA; color: #FFFFFF;" align="center" + |Myoglobinuria
-! style="background:#4479BA; color: #FFFFFF;" align="center" + |Other features
-! style="background:#4479BA; color: #FFFFFF;" align="center" + |History
-! style="background:#4479BA; color: #FFFFFF;" align="center" + |Physical
-Examination
-! style="background:#4479BA; color: #FFFFFF;" align="center" + |Laboratory Findings
-! style="background:#4479BA; color: #FFFFFF;" align="center" + |Creatine Kinase
-! style="background:#4479BA; color: #FFFFFF;" align="center" + |Muscle Biopsy
-! style="background:#4479BA; color: #FFFFFF;" align="center" + |Electromyogram
-|-
-! rowspan="3" style="background:#DCDCDC;" align="center" + |Neuromuscular
-! style="background:#DCDCDC;" align="center" + |[[Botulinum]]<ref name="pmid15257512">{{cite journal |vauthors=Cherington M |title=Botulism: update and review |journal=Semin Neurol |volume=24 |issue=2 |pages=155–63 |date=June 2004 |pmid=15257512 |doi=10.1055/s-2004-830901 |url=}}</ref>
-| style="background:#F5F5F5;" align="center" + |Variable
-| style="background:#F5F5F5;" align="center" + |Distal
-| style="background:#F5F5F5;" align="center" + |−
-| style="background:#F5F5F5;" align="center" + |−
-| style="background:#F5F5F5;" align="center" + | −
-| style="background:#F5F5F5;" align="center" + |<nowiki>+</nowiki>
-| style="background:#F5F5F5;" align="center" + |−
-| style="background:#F5F5F5;" align="center" + |−
-| style="background:#F5F5F5;" align="center" + |<nowiki>+</nowiki>
-| style="background:#F5F5F5;" align="center" + | −
-| style="background:#F5F5F5;" align="left" + |
-* [[Double vision]]
-* [[Blurred vision]]
-* Drooping eyelids
-* [[Slurred speech]]
-* [[Difficulty swallowing]]
-| style="background:#F5F5F5;" align="left" + |
-* H/O food exposure
-| rowspan="3" style="background:#F5F5F5;" align="left" + |
-* [[Hyporeflexia]]
-* Decreased strength
-| style="background:#F5F5F5;" align="left" + |
-* +Toxin
-| rowspan="3" style="background:#F5F5F5;" align="left" + |
-* Normal
-| rowspan="3" style="background:#F5F5F5;" align="left" + |
-* N/A
-| rowspan="3" style="background:#F5F5F5;" align="left" + |
-* Myopathic
-|-
-! style="background:#DCDCDC;" align="center" + |[[Lambert-Eaton syndrome|Lambert−Eaton syndrome]]<ref name="pmid22094130">{{cite journal |vauthors=Titulaer MJ, Lang B, Verschuuren JJ |title=Lambert-Eaton myasthenic syndrome: from clinical characteristics to therapeutic strategies |journal=Lancet Neurol |volume=10 |issue=12 |pages=1098–107 |date=December 2011 |pmid=22094130 |doi=10.1016/S1474-4422(11)70245-9 |url=}}</ref>
-| style="background:#F5F5F5;" align="center" + |Variable
-| style="background:#F5F5F5;" align="center" + |Distal
-| style="background:#F5F5F5;" align="center" + |−
-| style="background:#F5F5F5;" align="center" + | −
-| style="background:#F5F5F5;" align="center" + | +
-| style="background:#F5F5F5;" align="center" + | +
-| style="background:#F5F5F5;" align="center" + |−
-| style="background:#F5F5F5;" align="center" + |−
-| style="background:#F5F5F5;" align="center" + |<nowiki>+</nowiki>
-| style="background:#F5F5F5;" align="center" + |−
-| style="background:#F5F5F5;" align="left" + |
-* Weakness of the bulbar muscles
-* Ocular
-* Limb weakness
-| style="background:#F5F5F5;" align="left" + |
-* Weaknessa is often relieved temporarily after exertion or physical exercise.
-| style="background:#F5F5F5;" align="left" + |
-* Antibodies against voltage−gated calcium channels
-|-
-! style="background:#DCDCDC;" align="center" + |[[Myasthenia gravis]]<ref name="pmid23193443">{{cite journal |vauthors=Jayam Trouth A, Dabi A, Solieman N, Kurukumbi M, Kalyanam J |title=Myasthenia gravis: a review |journal=Autoimmune Dis |volume=2012 |issue= |pages=874680 |date=2012 |pmid=23193443 |pmc=3501798 |doi=10.1155/2012/874680 |url=}}</ref>
-| style="background:#F5F5F5;" align="center" + |Variable
-| style="background:#F5F5F5;" align="center" + |Proximal
-| style="background:#F5F5F5;" align="center" + |−
-| style="background:#F5F5F5;" align="center" + | −
-| style="background:#F5F5F5;" align="center" + | +
-| style="background:#F5F5F5;" align="center" + |<nowiki>+</nowiki>
-| style="background:#F5F5F5;" align="center" + |−
-| style="background:#F5F5F5;" align="center" + |−
-| style="background:#F5F5F5;" align="center" + |<nowiki>+</nowiki>
-| style="background:#F5F5F5;" align="center" + |−
-| style="background:#F5F5F5;" align="left" + |
-* [[Ocular]]
-* [[Bulbar]]
-* Limb weakness
-* Isolated neck, limbs and respiratory weakness
-| style="background:#F5F5F5;" align="left" + |
-* Weakness often worsens with activity
-| style="background:#F5F5F5;" align="left" + |
-* Antibodies that block or destroy nicotinic [[acetylcholine receptors]]
 |}

Polymyositis and dermatomyositis differential diagnosis: Difference between revisions

Revision as of 22:44, 19 April 2018

Overview

Differentiating

References

Navigation menu