Polymyositis vs Polymyalagia rhuematica - mr_hil22

[ArchivalUser]

What is the difference between this two.

[ArchivalUser]

Polymyositis, not polymyalgia rheumatica

Polymyositis is a disease of connective tissue whose cause is unknown and which is characterized by muscle degeneration with muscle weakness and pain, pain in several joints, dermatitis, swelling, and inflammation. Polymyalgia rheumatica, also poorly understood, is characterized by pain affecting the shoulders and hips, absence of inflammatory arthritis, no signs of muscle disease, and prompt response to low doses of steroids. It is important to distinguish between the two disorders to optimize treatment and prognosis, and usually this is not a problem. Muscle weakness and dysphagia (difficulty swallowing) often mark polymyositis, but when the muscle weakness is not conspicuous, it may be difficult to differentiate the two. Four cases seen in one year by a rheumatologist in which the initial - and incorrect - diagnosis was polymyalgia rheumatica are described. Three of the four cases initially had muscle pain and stiffness, but not weakness. These cases initially and partially responded to steroid therapy, but symptoms persisted and weakness developed, so that patients were then referred to specialists. Tests of muscle function were not ordered initially in three of the four patients. Polymyositis is rare compared with other musculoskeletal disorders that produce similar symptoms. It is associated with a higher risk of underlying malignancy, and treatment may require higher doses of steroids or other medication to suppress immune function. These cases illustrate the need for a full examination to distinguish between muscle stiffness and weakness and to evaluate levels of muscle-specific enzymes, so that these similar

[ArchivalUser]

Polymyositis: muscle damage with elevated muscle enzymes. May have dermatological manifestations (dermatomyositis).

PR: no muscle damage with normal enzymes. Only elevation of ESR is present. Associated with temporal arteritis.

[ArchivalUser]

PAIN is present in both but STIFFNESS is present only in Polymyalgia Rheumatica...correct me if I am wrong

Thanks,

[ArchivalUser]

polymyositis is a progressive,systemic connective tissue diease characterized by immune-mediated striated muscle inflammation.present with symmetric progressive,proximal muscle weakness;pain and difficulty breathing or swallowing (advanced disease)pat may develop myocaditis cardic conduction deficits.can be ass.with an underlying malignacy esp lung and breast cancer
dx-increased serum CK,ALDOLASE,ASTand ALT
EMG-shows fibrillation
Muscle biopsy-reveals inflammation and muscle fibers in varying stages of necrosis and degeneration
TX-high dose corticosteriod with taper after 4-6 weeks to decrease the maintenance dose
Azithiopine and /or methotrexate can be used as an adjunct

POLYMYALGIA RHEUMATICA
risk factors include female gender and age >50
HX/PE
pain and stiffness of the shoulder and pelvic girdle areas with difficult getting out of a chair or lifting the arms above the head
Often symtoms include fever malaise and weight loss.weakness is generally not appreciated on exam
DX-markedly increased ESR ,often associated with anemia
TX-low dose prdnisone (10-20mg/day

[ArchivalUser]

thanks all