12-07-2008, 06:50 AM
A 45 yr old woman comes to your officecomplainig of fatigue and weakness in her shoulderand hips that started a week ago.She reports difficulty in doinghousehold tasks,climibing stairs or rising from chair.She deniea any fascial or ocular weakness.The pt doesnt take any medication.Her family Hx is positiive for breast cancer in her mother.On exam when you apply opposing force to abduction of her armsshe is unable to produce full resistance.There is no limitation in the range of motion.The cardiac ,respire to,adominal and cutaneomucous exam are normal.ESR is 80 mm /hr,muscle enzymes are elvated.What is the best treatment for this pt?
A. Hip and shoulder replacement
B. Oral corticosteroids therapy
C. Prompt injection of high dose of corticosteroid
D. NSAID and antidepressant
E. Anticholinesterase inhibitors
A. Hip and shoulder replacement
B. Oral corticosteroids therapy
C. Prompt injection of high dose of corticosteroid
D. NSAID and antidepressant
E. Anticholinesterase inhibitors