Polymyositis: The Daily PANCE Blueprint

Polymyositis: The Daily PANCE Blueprint

What is (are) the major difference(s) between Polymyalgia Rheumatica (PMR) and polymyositis?

A. Marked proximal muscle weakness in polymyositis
B. Marked proximal muscle tenderness in polymyositis
C. Elevated muscle enzymes such as creatine kinase (CK) in polymyositis
D. a, b, and c

Answer and topic summary

The answer is D: a, b, and c

The differences between PMR and polymyositis on clinical examination are as follows:

  • There is marked weakness associated with proximal muscle pain in polymyositis
  • There is often marked muscle tenderness (versus joint pain in PMR) associated with the proximal muscle pain in polymyositis
  • Laboratory examination reveals elevated muscle enzymes only in polymyositis
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Polymyositis Pearls

Autoimmune-mediated inflammatory destruction of muscles leading to muscle weakness

  • Patients with polymyositis experience proximal symmetric (bilateral) muscle weakness
  • The shoulders and hips are the parts of the body most commonly affected by polymyositis
  • Early fatigue while walking and inability to rise from a seated position

Diagnosis

  • The three autoantibodies anti-Jo-1, anti-SRP, and anti-Mi-2, are associated with polymyositis
  • Creatine kinase levels are increased in polymyositis
  • Electromyography can detect regions of dead muscle cells
  • Muscle biopsy can show endomysial inflammation and various stages of necrosis

Treatment

  • Initial treatment of polymyositis  involves suppressing the immune response with corticosteroids
  • Methotrexate is used for long-term immunosuppressive therapy in polymyositis

Smarty PANCE Content Blueprint Review:

Covered under ⇒ PANCE Blueprint Musculoskeletal (8%)Rheumatologic Disorders (PEARLS)Polymyositis

 

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