eMedicine Specialties > Emergency Medicine > Cardiovascular
Myopathies: Differential Diagnoses & Workup
Updated: Nov 21, 2007
- Overview
- Differential Diagnoses & Workup
- Treatment & Medication
- Follow-up
Differential Diagnoses
Guillain-Barré Syndrome
Lambert-Eaton Myasthenic Syndrome
Myasthenia Gravis
Tick-Borne Diseases, Introduction
Workup
Laboratory Studies
- CK with isoenzymes
- Electrolytes, calcium, magnesium
- Serum myoglobin
- Serum creatinine and BUN
- Urinalysis: Myoglobinuria is indicated by positive urinalysis with few RBCs on microscopic evaluation.
- Complete blood count
- Erythrocyte sedimentation rate
- Thyroid function tests
- AST
Other Tests
- Electrocardiogram - Findings suggesting hypokalemia include the following:
- Diffuse nonspecific ST-T wave changes
- Increased PR interval
- U waves
- Wide QRS
- Steroid therapy should be withheld until a definitive diagnosis is made, but many tests that are essential for distinguishing among the varied causes of myopathy are out of the scope of the emergency physician. These tests include the following:
- Genetic testing
- Antinuclear antibody (ANA)
- MRI
- Electromyogram (EMG)
- Muscle biopsy
More on Myopathies |
| Overview: Myopathies |
Differential Diagnoses & Workup: Myopathies |
| Treatment & Medication: Myopathies |
| Follow-up: Myopathies |
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References
Ahlawat, S; Sachdev, A. Hypokalaemic paralysis. Postgrad Med J. 1999;75 (882):193-197. [Medline].
Bennett JC, Plum F. Myopathies. In: Cecil Textbook of Medicine. 20th ed. WB Saunders Co;1996:1500-03, 2158-73.
Fauci AS, Braunwald E, Isselbacher KJ, Wilson JD. In: Harrison's Principles of Internal Medicine. 14th ed. McGraw-Hill;1998:2473-2483.
Griggs RC, Ptacek LJ. The periodic paralyses. Hosp Pract (Off Ed). Nov 15 1992;27(11):123-6, 129-30, 136-7. [Medline].
Plate AM, Boyle BA. Musculoskeletal manifestations of HIV infection. AIDS Read. Feb 2003;13(2):62, 69-70, 72, 76. [Medline].
Riggs JE, Schochet SS, Joynt RJ, Griggs RC, eds. Muscle disease. In: Clinical Neurology. Vol 4. 1997:1-37.
Stedwell RE, Allen KM, Binder LS. Hypokalemic paralyses: a review of the etiologies, pathophysiology, presentation, and therapy. Am J Emerg Med. Mar 1992;10(2):143-8. [Medline].
Stobo JD, Hellman DB. Myopathies. In: The Principles and Practice of Medicine. 23rd ed. McGraw-Hill; 1996:898-904.
Tintinelli JE, Krome RL, Ruiz E. Emergency Medicine: A Comprehensive Study Guide. 4th ed. McGraw-Hill; 1996:1036.
Wortmann RL. Lipid-lowering agents and myopathy. Curr Opin Rheumatol. Nov 2002;14(6):643-7. [Medline].
Further Reading
Keywords
disorder of skeletal muscle, myonosus, sarcoidosis, polymyositis, dermatomyositis, idiopathic myopathies, connective tissue disease, systemic lupus erythematosus, SLE, rheumatoid arthritis, RA, polyarteritis nodosa, acute alcoholic myopathy, drug-induced myopathy, thyrotoxic periodic paralysis, Conn syndrome, primary hyperaldosteronism, muscular dystrophy
Differential Diagnoses & Workup: Myopathies