This is an important clinical distinction to make, but may not always be easy.
Myopathy (Break down or inflammation of muscle)
- Tends to affect (large) muscle groups (i.e Hips, Shoulders) causing proximal weakness.
- There will be a lack of sensory deficits (but they may complain of myalgias or tenderness to palpation (if myositis)).
- Reflexes should be intact and no fasciculations should be seen.
Neuropathy (Damage to your peripheral nerves)
- Tends to affect distal muscles first in a length dependent distribution.
- Typically will have sensory findings (i.e paresthesia, dysesthesia).
- May have loss of reflexes (i.e Lower Motor Neuron pathology).
- Fasciculations may be present.
NOTE: Tests such as CK and NCS/EMG can help delineate the two etiologies should the clinical picture not be clear.
- Saguil A. Evaluation of the patient with muscle weakness. Am Fam Physician. 2005 Apr 1;71(7):1327-36.
- Paganoni, S., Amato, A. Electrodiagnostic Evaluation of Myopathies. Phys Med Rehabil Clin N Am. 24 (2013) 193–207.
- Chawla, J. Stepwise Approach to Myopathy in Systemic Disease. Front Neurol. 2011; 2: 49.
The two drugs are not interchangeable nor dose equivalents. Mycophenolate mofetil is a semi synthetic…
Serum Creatinine can be a deceptive surrogate during an acute kidney injury. It may lag…
Macrophage activation syndrome (MAS) is a life-threatening complication of rheumatic diseases (i.e SLE, Juvenile idiopathic…
After creation of a percutaneous tracheotomy site for prolonged ventilation, one of the immediate complications…
Two systematic reviews have assessed the diagnostic accuracy of elements of the medical history, physical…
SYMPTOMS THAT RULE OUT (Lowest -LR): The absence of pain of sudden onset substantively decreases…