Myositis (peds): Difference between revisions
ClaireLewis (talk | contribs) No edit summary |
No edit summary |
||
| (One intermediate revision by one other user not shown) | |||
| Line 1: | Line 1: | ||
{{Peds top}} [[myositis]] | |||
==Background== | ==Background== | ||
*[[Influenza]] is one of the most common causes of viral myositis | *[[Influenza]] is one of the most common causes of viral myositis | ||
| Line 21: | Line 22: | ||
*Supportive | *Supportive | ||
*Fluids ([[IVF]] or oral) | *Fluids ([[IVF]] or oral) | ||
*Analgesia; avoid [[NSAIDs]] | *[[Analgesia]]; avoid [[NSAIDs]] | ||
==Disposition== | ==Disposition== | ||
Latest revision as of 23:38, 28 November 2019
This page is for pediatric patients. For adult patients, see: myositis
Background
- Influenza is one of the most common causes of viral myositis
- Rhabdo is unusual but has been reported.
Clinical Features
- Patients usually have a history of recent illness (fever, URI symptoms, etc)
- Significant myalgias as starting to improve from constitutional symptoms
- Most commonly lower legs
- Can have pain and tenderness in other muscle groups (thighs, arms)
- Usually look well, but will sometimes walk with wide gait and on their toes
- When lying in bed, will often keep toes pointed with pain in calves upon dorsiflexion
Differential Diagnosis
Myalgia
- Infection:
- Viral infection (e.g. Influenza)
- Bacterial infection
- Spirochete infection (E.g. Dengue fever; Trichinella)
- Drugs:
- Statins
- Bisphosphonates
- Corticosteroids
- Ciprofloxacin
- Clofibrate
- Colchicine
- Chloroquine
- Emetine
- Aminocaproic acid
- Zidovudine
- Bretylium
- Penicillamine
- Drugs causing hypokalemia
- Metabolic disorders:
- Vitamin D deficiency
- Mitochondrial myopathy
- Scurvy
- Osteomalacia
- Fibromyalgia
- Endocrine:
- Polymyalgia rheumatica
- Rhabdomyolysis
- Myositis
- Systemic lupus erythematosus
- Rheumatoid arthritis
- Inclusion body myositis
- Sarcoidosis
- Scleroderma
- Sjögren’s syndrome
- Psychiatric (e.g. somatic manifestations of depression)
- Domestic abuse
- Crush injury
- Lyme disease
- Ehlers-Danlos syndrome(hypermobility syndrome)
- HIV myopathy
- Hypophosphatemia
- Hypokalemia
- Hypothermia
- Prolonged immobility
- Strenuous exercise (overuse) or heat stroke
- Seizure
- Severe volume contraction
- Alcoholism
- Muscular dystrophy
- Duchenne
- Becker
- Limb-girdle
- Facioscapulohumeral
- Myotonic dystrophy
- Myotonia congenita
- Compartment syndrome; Muscle infarction
- Neuropathic
- Chronic fatigue syndrome
- Vasculitis
- Sarcocystosis
- Spinal stenosis
- Diabetic lumbosacral plexopathy
Evaluation
- Total CK
- UA (for myoglobin)
Management
Disposition
- Discharge with close outpatient follow up if CPK <3,000 and able to orally hydrate [1]