Myalgia: Difference between revisions
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==Differential Diagnosis== | ==Differential Diagnosis== | ||
*Infection: Viral infection | *Infection: | ||
*Drugs: Statins | **Viral infection (e.g. [[Influenza virus]]) | ||
*Metabolic disorders: Vitamin D deficiency; Mitochondrial myopathy; Scurvy; Osteomalacia | **Bacterial infection | ||
**Spirochete infection (E.g. [[Dengue fever]]; [[Trichinella infection]]) | |||
*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 | *Fibromyalgia | ||
*Endocrine: hypothyroidism; hyperthyroidism; Cushing’s syndrome; Adrenal insufficiency; Hyperparathyroidism | *Endocrine: | ||
**hypothyroidism; | |||
**hyperthyroidism; | |||
**Cushing’s syndrome; | |||
**Adrenal insufficiency; | |||
**Hyperparathyroidism | |||
*Polymyalgia rheumatica | *Polymyalgia rheumatica | ||
*Rhabdomyolysis (and anything that can cause rhabdomyolysis) | *Rhabdomyolysis (and anything that can cause rhabdomyolysis) | ||
Revision as of 00:26, 2 April 2019
Background
Clinical Features
Differential Diagnosis
- Infection:
- Viral infection (e.g. Influenza virus)
- Bacterial infection
- Spirochete infection (E.g. Dengue fever; Trichinella infection)
- 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:
- hypothyroidism;
- hyperthyroidism;
- Cushing’s syndrome;
- Adrenal insufficiency;
- Hyperparathyroidism
- Polymyalgia rheumatica
- Rhabdomyolysis (and anything that can cause rhabdomyolysis)
- Myositis (muscle inflammation): e.g, polymyositis, dermatomyositis
- Systemic lupus erythematosus (SLE)
- 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 (Hypermobility syndrome)
- HIV myopathy
- Hypophosphatemia
- Hypokalemia
- Hypothermia
- Prolonged immobility, eg, after a drug overdose.
- Strenuous exercise (overuse) or heat stroke
- Seizure
- Severe volume contraction
- Alcoholism
- Muscular dystrophy, eg, Duchenne, Becker, limb-girdle, facioscapulohumeral (FSH); Myotonic dystrophy; Myotonia congenita
- Compartment syndrome; Muscle infarction
- Neuropathic
- Chronic fatigue syndrome
- Vasculitis
- Sarcocystosis
- Spinal stenosis
- Diabetic lumbosacral plexopathy
Evaluation
- Myalgias can be divided into diffuse (systemic) myalgias vs. Localized myalgias.
- Muscle pain can come from Rhabdomyolysis, Myositis, or Myopathy.