Myopathy

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Myopathy

Examination

• Observation
  • wasting
    • proximal > distal
• tone
  • normal
• Power
  • proximal weakness
    • hip flexion / extension weak
    • ankle dorsi-/plantarflexion normal
• Reflexes
  • normal (?depressed)
• sensation
  • normal
• coordination
  • normal
• Gait
  • waddling
• Extras
  • unable to rise from chair without hands
  • unable to rise from crouching position

Causes

• inflammatory
  • Polymyositis
  • Dermatomyositis
• metabolic / endocrine
  • Cushing's Syndrome
  • Hyperthyroidism
  • Hypothyroidism
• muscular dystrophies
  • Duchenne Muscular Dystrophy
  • Becker Muscular Dystrophy
  • Myotonic Dystrophy
    • only non-proximal myopathy
• Polymyalgia Rheumatica
• paraneoplastic

Exclude

• Pyramidal disease
• Diabetic femoral amyotrophy

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