58 Proximal myopathy Instruction Perform a neurological examination of this patient’s arms or legs. Salient features History • Weakness of proximal muscles • Patient has difficulty in standing from the sitting position (getting up from chairs, getting off the commode) or difficulty in combing hair – elicit this history. Examination • Check the gait, looking for waddling gait (p. 251) • Look for an underlying cause: • Diabetic amyotrophy (asymmetrical, usually in the lower limbs in non-insulin-dependent diabetes mellitus) • Cushing syndrome (characteristic facies, history of steroid ingestion; see p. 538) • Thyrotoxicosis (look for eye signs, goitre, rapid pulse, tremor) • Polymyositis (heliotropic rash, tender muscles) Only gold members can continue reading. Log In or Register to continue Share this:Click to share on Twitter (Opens in new window)Click to share on Facebook (Opens in new window)Like this:Like Loading... Related Related posts: Permanent cardiac pacemaker/implantable cardioverter-defibrillator Wallenberg’s syndrome (lateral medullary syndrome) Anaemia Superior vena caval obstruction Stay updated, free articles. Join our Telegram channel Join Tags: 250 Cases in Clinical Medicine Dec 4, 2016 | Posted by admin in GENERAL & FAMILY MEDICINE | Comments Off on Proximal myopathy Full access? Get Clinical Tree
58 Proximal myopathy Instruction Perform a neurological examination of this patient’s arms or legs. Salient features History • Weakness of proximal muscles • Patient has difficulty in standing from the sitting position (getting up from chairs, getting off the commode) or difficulty in combing hair – elicit this history. Examination • Check the gait, looking for waddling gait (p. 251) • Look for an underlying cause: • Diabetic amyotrophy (asymmetrical, usually in the lower limbs in non-insulin-dependent diabetes mellitus) • Cushing syndrome (characteristic facies, history of steroid ingestion; see p. 538) • Thyrotoxicosis (look for eye signs, goitre, rapid pulse, tremor) • Polymyositis (heliotropic rash, tender muscles) Only gold members can continue reading. Log In or Register to continue Share this:Click to share on Twitter (Opens in new window)Click to share on Facebook (Opens in new window)Like this:Like Loading... Related Related posts: Permanent cardiac pacemaker/implantable cardioverter-defibrillator Wallenberg’s syndrome (lateral medullary syndrome) Anaemia Superior vena caval obstruction Stay updated, free articles. Join our Telegram channel Join Tags: 250 Cases in Clinical Medicine Dec 4, 2016 | Posted by admin in GENERAL & FAMILY MEDICINE | Comments Off on Proximal myopathy Full access? Get Clinical Tree
