Rheumatology Book

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Muscle Weakness

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  1. Evaluation
    1. Distinguish weakness from Fatigue and Asthenia
      1. Asthenia is exhaustion without weakness
      2. Fatigue is inability to perform task repeatedly
      3. Weakness is inability to perform task initially
    2. Determine distribution
      1. Unilateral, focal weakness
        1. Mononeuropathy
        2. Multiple Sclerosis
        3. Cerebrovascular Accident (CVA)
      2. Symmetric proximal weakness
        1. Myopathy
      3. Symmetric distal weakness
        1. Polyneuropathy
        2. Amyotrophic Lateral Sclerosis
        3. Guillain-Barre Syndrome
        4. Myopathy less commonly effects distal muscles
          1. Statins, Alcohol may effect distal and proximal
          2. Inclusion body Myositis
          3. Myotonic dystrophy
    3. Consider specific causes
      1. See Muscle Weakness Causes
      2. See Neuropathy
      3. See Toxic Myopathy
  2. Diagnostic evaluation based on category
    1. See Neuropathy
    2. Myopathy (see also Polymyositis)
      1. Creatine Kinase (CPK)
      2. Erythrocyte Sedimentation Rate
      3. Serum chemistry (e.g. Chem 8)
        1. Electrolytes glucose, calcium, magnesium, phosphate
      4. Thyroid Stimulating Hormone (TSH)
      5. Other tests as indicated
        1. 24-hour urine cortisol
        2. Growth Hormone
        3. Antinuclear Antibody
      6. Definitive testing
        1. Electromyogram
        2. Muscle Biopsy

Muscle Weakness (C0151786)

Definition (MSH)A vague complaint of debility, fatigue, or exhaustion attributable to weakness of various muscles. The weakness can be characterized as subacute or chronic, often progressive, and is a manifestation of many muscle and neuromuscular diseases. (From Wyngaarden et al., Cecil Textbook of Medicine, 19th ed, p2251)
Definition (NCI)A reduction in the strength of one or more muscles.
ConceptsFinding (T033)
ICD9728.87
EnglishDecreased muscle strength, Muscle strength reduced, Muscle weakness, Muscle Weaknesses, Muscular Weakness, Muscular Weaknesses, WEAKNESS MUSCLE
Spanishdebilidad muscular, fuerza muscular disminuida, paresia
CreditsDerived from the NIH UMLS (Unified Medical Language System)



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