Myalgia differential diagnosis
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Myalgia differential diagnosis
The most common causes of myalgia are overuse, injury or stress[1]. However, myalgia can also be caused by diseases, disorders, medications, as a response to vaccination and withdrawal syndromes.
Overuse
Overuse of a muscle is using it too much, too soon and/or too often. [1] Examples are:
Injury
The most common causes of myalgia by injury are: sprains and strain (injury)[1].
Diseases/Disorders
Infectious
Trichinosis, Typhoid fever, Upper respiratory tract infection, Viral pneumonia, Influenza, Common cold,Community-acquired pneumonia, Coccidioidomycosis, Dengue, Endemic typhus, HIV, Infectious mononucleosis,Legionellosis, Leptospirosis, Lyme disease, Malaria, Marburg virus, Meningitis, Monkeypox,Pharyngitis, Pneumonia, Prostatitis, Psittacosis, Q fever, Rabies, Rift Valley fever, Severe acute respiratory syndrome (SARS), Toxic shock syndrome, West Nile, Chikungunya
Autoimmune
Multiple sclerosis, Myositis, Lupus erythematosus, Familial Mediterranean fever, Polyarteritis nodosa, Devic's disease, Morphea
Metabolic defect
Carnitine palmitoyltransferase II deficiency, Conn's syndrome, Adrenal insufficiency
Other
Chronic fatigue syndrome, Hypokalemia, Exercise intolerance, Mastocytosis, Peripheral neuropathy, Eosinophilia myalgia syndrome, Fibromyalgia, Barcoo Fever, Delayed onset muscle soreness
Medications
Aldara, Acrylamide, Darbepoetin, Isotretinoin, Procainamide, Quinupristin/dalfopristin, Spiriva,Sumatriptan, Vardenafil, Statins, Zetia, Zomig, Boniva
As a Response to Vaccination
A moderate occurrence (25-35%) of myalgia in recipients of tetanus vaccination is identified in the US; it presents in the large muscle groups and at the subcutaneous injection site. When a patient returns with these symptoms (which include fever, poor appetite and lethargy), a clinician who fails to notice the recent tetanus vaccination on the patient's chart is in danger of making a life-threatening misdiagnosis.
- An item of note is that in heart patients using selective β1-blockers such as metoprolol, incidence of myalgia after tetanus vaccination is significantly higher.
Withdrawal Syndromes
Sudden cessation of opioids, barbiturates, benzodiazepines, or alcohol can induce myalgia.
References
- ↑ 1.0 1.1 1.2 MedlinePlus