]> 2026-07-31T07:53:05+00:00 WBR1031 0 en Polymyositis Dermatomyositis Neuromuscular junction disease '''Incorrect'''-Neuromuscular junction disease usually presents as muscle weakness that is decremental in nature and descends from the face with bilateral ptosis, dysarthria, etc. to the proximal muscles of the limbs while also involving the respiratory muscles. Drug induced myopathy '''Correct'''-Acute steroid induced myopathy should be considered in patients who begin to have generalized muscle weakness, elevated serum creatinine kinase levels and myoglobinuria around 1 week after the start of steroid treatment. Polymyalgia rheumatica Community Medical Health Center Primary Care Office Vendhan Ramanujam A 49 year old man presents to his primary care physician with complaints of generalized muscle weakness and pain present all throughout the day for the past three days. It started as a vague neck pain before progressing to generalized muscle weakness. He also complains of drooping of his upper eyelids and inability to open his car doors because of hand weakness. Over-the-counter acetaminophen has not been helpful. He denies any history of fever, difficulty in breathing or swallowing and facial muscle weakness. He has a past medical history of gastroesophageal reflux disease and plantar fasciitis that was diagnosed before 1 week for which he is currently taking methylprednisolone. He has a history of smoking 1 pack of cigarette per day for the past 25 years and denies taking alcohol. On examination, his vital signs are blood pressure of 130/85 mm Hg, pulse rate of 80 beats/min, respiratory rate of 15 breaths/min and temperature of 37.2 °C. Bilateral ptosis is noticed and there is pain on palpation of both the upper and lower extremity. Muscle strength is 2 in both the upper and lower extremities. Handgrip is weak, and he has difficulty standing up from sitting position. Sensations are bilaterally normal and symmetrical. Normal deep tendon reflexes are noted. His complete blood count and basic metabolic profile are normal. His other lab tests revealed the following<br> ESR : 10 mm/hr<br> Creatinine phosphokinase: 890 U/L<br> C-reactive protein : 14 mg/L<br> <br> A urine dipstick test is positive for hemoglobin. Muscle biopsy and electromyography are not performed. What is the most likely cause for this patient’s complaints? D Musculoskeletal/Rheumatology 2020-10-28T02:25:18Z 2459150.6009028 WBR1031