Case:04 Weakness: Difference between revisions
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*B12 normal 305 | *B12 normal 305 | ||
=Imaging 1= | =Imaging= | ||
MRI bilateral | <gallery mode=packed heights=250px> | ||
File:MRI myositis T2 increased muscle signal.jpg | |||
File:MRI myositis T1 vastus lateralis fatty atrophy.jpg|400px | |||
</gallery> | |||
{{DICOM Link|1.2.276.0.7230010.3.1.2.3580904999.1439.1718437062.741080}} | |||
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|title=MRI bilateral femur report | |||
|text= | |||
*bilateral hip replacements causes substantial metallic artefact obscuring the hip joints, supperior adductor muscles, and small external rotators. | *bilateral hip replacements causes substantial metallic artefact obscuring the hip joints, supperior adductor muscles, and small external rotators. | ||
*Bilateral trochanteric bursal effusions | *Bilateral trochanteric bursal effusions | ||
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*No bone oedema | *No bone oedema | ||
*Findings consistent with acute muscle inflammation involving both the quadriceps and adductor compartments. Findings are consistent with an inflammatory myopathy however MRI is non specific for the cause of myositis. MRI can guide biopsy if clinically appropriate. | *Findings consistent with acute muscle inflammation involving both the quadriceps and adductor compartments. Findings are consistent with an inflammatory myopathy however MRI is non specific for the cause of myositis. MRI can guide biopsy if clinically appropriate. | ||
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=Diagnosis= | =Diagnosis= | ||
Symptoms and signs are consistent with a diagnosis of inclusion body myositis. The CN-1A antibodies are positive in only 60% of IBM cases. There is no treatment or cure for IBM. The best management is regular exercise and physiotherapy. | Symptoms and signs are consistent with a diagnosis of inclusion body myositis with the proximal lower limb and distal upper limb pattern of painless progressive weakness in an elderly man. The CN-1A antibodies are positive in only 60% of IBM cases. There is no treatment or cure for IBM. The best management is regular exercise and physiotherapy. | ||
He also has a separate age related length dependent peripheral neuropathy. | |||
Read more about [[Myositis]] | Read more about [[Myositis]] |