Sandbox Myopathy: Difference between revisions

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Aditya Ganti (talk | contribs)
Bureaucrats, bureaucrats, nocaptcha, Administrators
11,402 edits
No edit summary
Line 6: Line 6:
{| class="wikitable"
{| class="wikitable"
! rowspan="3" |
! rowspan="3" |
! colspan="7" |Symptoms
! colspan="8" |Symptoms
! colspan="2" |Physical Examination
! rowspan="3" |History
! rowspan="3" |Physical
Examination  
! colspan="5" |Diagnosis
! colspan="5" |Diagnosis
|-
|-
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! colspan="2" |Muscle weakness
! colspan="2" |Muscle weakness
! rowspan="2" |Fatigue
! rowspan="2" |Fatigue
! rowspan="2" |Myalgia
! rowspan="2" |Muscle pain
! rowspan="2" |Cramps
! rowspan="2" |Neuropathy
! rowspan="2" |Myoglobinuria
! rowspan="2" |Myoglobinuria
! colspan="3" rowspan="2" |
! rowspan="2" |Other features
! rowspan="2" |Laboratory Findings
! colspan="2" rowspan="2" |Laboratory Findings
! rowspan="2" |Creatine Kinase
! rowspan="2" |Creatine Kinase
! rowspan="2" |Muscle Biopsy
! rowspan="2" |Muscle Biopsy
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!DIstal
!DIstal
|-
|-
! colspan="15" |Medications
! colspan="16" |Medications
|-
|-
|Corticosteroids
|Corticosteroids
|Variable
|<nowiki>+</nowiki>
|<nowiki>-</nowiki>
|<nowiki>-</nowiki>
|<nowiki>+</nowiki>
| -
|<nowiki>-</nowiki>
|
|
* Central obesity
* Excessive [[sweating]]
* [[Insomnia]]
* Reduced [[libido]] 
* [[Amenorrhoea|Amenorrhea]]
* [[Infertility]] 
* Psychological disturbances
|
|
*
|
|
|
* Facial and sphincter muscles usually are spared
|
| colspan="2" |
|
|
|
|
|
|
|
|
|
|
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|-
|-
|Statins
|Statins
|60+
|<nowiki>+</nowiki>
|<nowiki>-</nowiki>
|<nowiki>-</nowiki>
|<nowiki>+</nowiki>
| -
|<nowiki>-/+(rhabdomyolysis)</nowiki>
|
|
|
|
* Positive medication history
|
|
* Tenderness
* Muscle aches
| colspan="2" |
|'''↑↑'''
|
|
|
* Necrosis
|
* Degeneration, and regeneration of fibers
|
* Phagocytic infiltration
|
|<nowiki>-</nowiki>
|
|
|
|
|
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|-
|-
|Anti-Thyroid  
|Anti-Thyroid  
|
|
|
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|
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|-
|-
|Chemotherapeutic
|Chemotherapeutic
|
|
|
|
|
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|-
|-
|Organophosphate intoxication
|Organophosphate intoxication
|
|
|
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|
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|
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|
|
|
* Change in mental status
* Telangiectasia
* Peripheral neuropathy
|
|
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|
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|
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|-
|-
! colspan="15" |Endocrine  
! colspan="16" |Endocrine  
|-
|-
|Adrenal insufficiency
|Adrenal insufficiency
|
|
|
|
|
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|-
|-
|Cushing's disease
|Cushing's disease
|
|
|
|
|
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|-
|-
|Secondary hyperparathyroidism
|Secondary hyperparathyroidism
|
|
|
|
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|-
|-
|Hyperthyroidism
|Hyperthyroidism
|
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|
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|-
|-
|Hypothyroidism
|Hypothyroidism
|
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|
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|
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|-
|-
! colspan="15" |Inflammatory / Rheumatologic  
! colspan="16" |Inflammatory / Rheumatologic  
|-
|-
|Dermatomyositis
|Dermatomyositis
|
|
|
|
|
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|-
|-
|Polymyositis
|Polymyositis
|
|
|
|
|
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|-
|-
|Inclusion body myositis
|Inclusion body myositis
|
|
|
|
|
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|-
|-
|Fibomyalgia
|Fibomyalgia
|
|
|
|
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|-
|-
|Polymyalgia Rheumatica
|Polymyalgia Rheumatica
|
|
|
|
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|-
|-
|Chronic Pain Syndrome
|Chronic Pain Syndrome
|
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|
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|
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|-
|-
! colspan="15" |Genetic
! colspan="16" |Genetic
|-
|-
|Becker muscular dystrophy
|Becker muscular dystrophy
|
|
|
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|-
|-
|Limb-girdle muscular dystrophies
|Limb-girdle muscular dystrophies
|
|
|
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|-
|-
|Myotonic dystrophy type 1
|Myotonic dystrophy type 1
|
|
|
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|
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|-
|-
! colspan="15" |Infectious
! colspan="16" |Infectious
|-
|-
|Lyme disease
|Lyme disease
|
|
|
|
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|-
|-
|Infulenza
|Infulenza
|
|
|
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|-
|-
|Polio
|Polio
|
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|
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|-
|-
|Syphilis
|Syphilis
|
|
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|-
|-
|HIV
|HIV
|
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|
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|-
|-
! colspan="15" |Neurologic
! colspan="16" |Neurologic
|-
|-
|ALS
|ALS
|
|
|
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|-
|-
|Stroke
|Stroke
|
|
|
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|-
|-
|GBS
|GBS
|
|
|
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|-
|-
|Multiple Sclerosis
|Multiple Sclerosis
|
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|
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|-
|-
! colspan="15" |Neuro-muscular  
! colspan="16" |Neuro-muscular  
|-
|-
|Botulisim
|Botulisim
|
|
|
|
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|-
|-
|Lambert-Eaton myaes
|Lambert-Eaton myaes
|
|
|
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|-
|-
|Myasthenia gravis
|Myasthenia gravis
|
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|-
|-
! colspan="15" |Paraneoplastic
! colspan="16" |Paraneoplastic
|-
|-
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|-
|-
! colspan="15" |Metabolic
! colspan="16" |Metabolic
|-
|-
|Glycogen storage disease
|Glycogen storage disease
|
|
|
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|-
|-
|Lipid storage disease
|Lipid storage disease
|
|
|
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|-
|-
|Mitochondrial
|Mitochondrial
|
|
|
|
|

Revision as of 12:13, 28 March 2018


Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Differentiating Various Muscle Weakness

Symptoms History Physical

Examination

Diagnosis
Age of onset Muscle weakness Fatigue Muscle pain Neuropathy Myoglobinuria Other features Laboratory Findings Creatine Kinase Muscle Biopsy Electromyogram
Proximal DIstal
Medications
Corticosteroids Variable + - - + - -
  • Facial and sphincter muscles usually are spared
Statins 60+ + - - + - -/+(rhabdomyolysis)
  • Positive medication history
  • Tenderness
  • Muscle aches
 ↑↑
  • Necrosis
  • Degeneration, and regeneration of fibers
  • Phagocytic infiltration
 -
Anti-Thyroid
Chemotherapeutic
Organophosphate intoxication
Alcohol Variable +
  • Change in mental status
  • Telangiectasia
  • Peripheral neuropathy
Endocrine
Adrenal insufficiency
Cushing's disease
Secondary hyperparathyroidism
Hyperthyroidism
Hypothyroidism
Inflammatory / Rheumatologic
Dermatomyositis
Polymyositis
Inclusion body myositis
Fibomyalgia
Polymyalgia Rheumatica
Chronic Pain Syndrome
Genetic
Becker muscular dystrophy
Limb-girdle muscular dystrophies
Myotonic dystrophy type 1
Infectious
Lyme disease
Infulenza
Polio
Syphilis
HIV
Neurologic
ALS
Stroke
GBS
Multiple Sclerosis
Neuro-muscular
Botulisim
Lambert-Eaton myaes
Myasthenia gravis
Paraneoplastic
Metabolic
Glycogen storage disease
Lipid storage disease
Mitochondrial
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