Dermatomyositis Quiz: Ace Your Exams

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A 47-year-old man comes to the outpatient provider because of a 5-month history of weakness in the shoulders and hip muscles. The patient reports having difficulty getting out of a chair and climbing stairs. The patient has no other medical conditions and previously led an active lifestyle. Temperature is 37.8°C (100.0°F), blood pressure is 122/68 mmHg, pulse is 67/min, and respiratory rate is 12/min. Physical examination is notable for tenderness and weakness in the shoulder and hip muscles. The following is also noted on bilateral ocular examination:

Reproduced from: Wikimedia Commons

Which of the following findings is most specific to the patient’s condition?

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Elevated serum creatinine kinase level

Muscle biopsy revealing endomysial CD8+ lymphocyte infiltration

Radiograph revealing vertebral body erosion with reactive sclerosis

Muscle biopsy revealing perimysial CD4+ lymphocyte infiltration

Elevated peripheral blood eosinophil count