Rheumatology Book


Primary Idiopathic Polymyositis

Aka: Primary Idiopathic Polymyositis
  1. See Also
    1. Polymyositis
    2. Dermatomyositis
  2. Pathophysiology
    1. Group I of Polymyositis disorders (accounts for 33%)
  3. Epidemiology
    1. Incidence higher in women by ratio of 2:1
  4. Course
    1. Insidiously progressive over weeks to years
  5. Symptoms: Proximal limb weakness
    1. Hip and Thigh weakness (Most significant)
      1. Difficult rising from seated/kneeling position
      2. Difficult climbing/descending stairs
      3. Unable to walk (5%)
    2. Shoulder Muscle Weakness
      1. Difficulty reaching overhead (e.g. combing hair)
    3. Buttock, thigh, or calf aching (10%)
      1. Tenderness to palpation (20%)
  6. Symptoms: Other
    1. Dysphagia (25%)
    2. Weakness of extensor neck Muscles
    3. Respiratory Impairment (5%)
    4. Cardiac involvement (30%)
      1. Electrocardiogram (EKG) change or Arrhythmia
      2. Congestive Heart Failure secondary to Myocarditis
  7. Signs
    1. Proximal Muscle Weakness
    2. Distal Muscle sparing in 75%
    3. Muscles tender to palpation with signs of atrophy
    4. Gait slow and waddling
  8. Differential Diagnosis
    1. See Polymyositis Differential Diagnosis
  9. Evaluation
    1. See Polymyositis Evaluation
  10. Management
    1. See Polymyositis Management
  11. References
    1. Koler (2001) Am Fam Physician 64(9):1565-72 [PubMed]

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