Skip to content

Myalgias and myositis: Pathology review

Videos

Notes

Pathology

Musculoskeletal system

Pediatric musculoskeletal conditions
Musculoskeletal injuries and trauma
Bone disorders
Joint disorders
Muscular disorders
Neuromuscular junction disorders
Other autoimmune disorders
Musculoskeletal system pathology review

Assessments
Myalgias and myositis: Pathology review

Questions

1 / 7 complete
Questions

USMLE® Step 1 style questions USMLE

7 questions

USMLE® Step 2 style questions USMLE

1 questions
Preview

A 41-year-old woman is evaluated by the outpatient physician for 5-months of generalized fatigue and diffuse soft-tissue pain. The pain is present in the upper extremities, lower extremities, and back. She feels tired every morning despite getting adequate sleep in the evening. Past medical history is notable for hypertension that is currently managed with propranolol. Temperature is 37.2°C (98.9°F), blood pressure is 136/88 mmHg, pulse is 61/min, and respiratory rate is 15/min. Physical examination reveals 5/5 strength and full range-of-motion in the upper and lower extremities. Soft-tissue tenderness is elicited at multiple locations across the patient’s body. Laboratory results are as follows:  

 

Laboratory value  Result
 Hemoglobin  14.8 g/dL 
 Leukocyte  7,800/mm3 
 Erythrocyte sedimentation rate (ESR)   7 mm/h 
 Serum creatinine kinase  27 U/L 
 Antinuclear antibodies  Negative 

Which of the following additional findings would most likely be found in this patient?

Transcript

Content Reviewers:

Yifan Xiao, MD

On your rounds, you see two individuals. First is Yu Yan, a 58-year-old female who presents with a 2-week history of fatigue, weight loss, fevers, and bilateral pain with stiffness in the shoulder and hip girdles. These symptoms are worse at night and last for more than an hour. She also mentions that she finds it hard to get out of bed in the morning due to stiffness. On examination, her wrists and finger joints are painful and swollen, but there’s no muscle weakness. Then you see Elizabeth, a 38-year-old female who has a 4-year history of body pain. The pain was initially limited to her neck, but it has gradually spread and she now complains of constant pain all over. She does not sleep well and is chronically fatigued. Examination revealed many tender points throughout her body but no sign of joint swelling or muscle weakness. Blood tests were performed in both. In Yu Yan’s case, there was an increase in inflammatory markers, but creatine kinase levels were normal. In Elizabeth’s, blood tests were completely