Signs
 

Proximal Myopathy

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Overview

    • Signs of Proximal Myopathy

    • General Signs

    • Proximal muscle wasting - biceps, deltoids, quadriceps, buttocks
    • Symmetrical proximal weakness - particularly the shoulder and hip muscles
    • Trendelenberg gait - dropping of the affected side during the stance phase
    • Trendelenberg test - dropping of the affected hip on standing on the opposite leg
    • Signs Suggesting a Cause

    • Dermatomyositis - heliotrope rash, Gottron’s papules
    • Paraneoplastic syndrome - surgical scars, e.g. in the chest
    • Causes of Proximal Myopathy

    • Congenital

    • Muscular dystrophy - e.g. Duchenne’s, Becker’s, Emery-Dreyfuss, limb girdle, fascioscapulohumeral
    • Metabolic myopathies - e.g. glycogen and lipid storage disorders
    • Acquired

    • Inflammatory myositis - polymyositis, dermatomyositis
    • Paraneoplastic syndrome
    • Infection - Lyme disease, HIV, infectious pyomyositis, trichinosis, cysticercosis, coxsackievirus
    • Endocrine - thyroid disease, Cushing’s, acromegaly, hypopituitarism
    • Metabolic - periodic paralysis
    • Toxins - alcohol, steroids, statins, cocaine
    • Sarcoidosis
    • Proximal Muscles of the Upper Limb

    • Deltoids
    • Biceps
    • Triceps
    • Brachioradialis
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