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12 Cards in this Set
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S/Sx suggestive of myopathy
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1) Proximal Symmetric weakness, which may be acute, subacute, or chronic
2) Reduced, preserved, or enlarged muscle bulk 3) Muscle pain or discomfort with palpation (myalgia) 4) Muscle stiffness or cramps 5) Asthenia and fatigue 6) Myoglobinuria |
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General categories of myopathies
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1) Inflammatory
2) Muscular dystrophies 3) Congenital myopathies 4) Metabolic myopathies 5) Mitochondrial myopathies 6) Toxic myopathies 7) Endocrine myopathies 8) Infectious myopathies |
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MRC grade 0 muscle strength
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no movement
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MRC grade 1 muscle strength
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trace movement
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MRC grade 2 muscle strength
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able to move, but not aginst gravity
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MRC grade 3 muscle strength
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able to move full range against gravity
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MRC grade 4 muscle strength
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able to move against some resistance
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MRC grade 5 muscle strength
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normal strength
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3 most valuable tests for evaluation of muscle disease
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serum CK, EMG, muscle bx
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What conditions, other than myopathies, increase CK?
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exercise
increased muscle bulk muscle trauma viral illness AA race drug use eatting licorice hypothyroidism hypoparathyroidism malignant hyperthermia neurogenic dz (e.g. ALS) benign hereditary CK elevation **typically < 3-fold in these. >5-fold increase suggestive of myopathy |
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Type of exercise and CK elevation
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eccentric exercise causes greater increase in CK than concentric
eccentric: lengthening of muscle concentric: shortering of muscles |
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Indication for muscle biopsy?
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muscle weakness with laboratory or EDX evidence of myopathy
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