Proximal myopathy
Incidental findings Stigmata steroid usage
+ve signs Proximal muscle weakness, difficulty standing from chair / from squatting
Differential diagnosis As below
Function ?Disabled
Tests CK, EMG
TFTs
Vitamin D
Causes
Endocrine: Cushing’s, Thyrotoxicosis
Inflammatory: Polymyositis/dermatomyositis
Osteomalacia
Carcinomatous
Notes

  • PMR causes proximal stiffness, tenderness but muscle strength near normal
  • Other causes: McArdle’s, mitochondiral myopathy, uraemia