The Curbsiders Internal Medicine Podcast

#348 Myositis and Myopathy, LIVE!

5 snips
Aug 1, 2022
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ADVICE

Differentiate True Weakness From Fatigue

  • Ask whether weakness is true weakness versus fatigue by using functional examples (e.g., difficulty rising from a low chair).
  • Query specific tasks like using chair arms or getting out of a deep seat to distinguish weakness from deconditioning.
ADVICE

Positioning Reveals Proximal Weakness

  • Test hip and neck flexors with the patient supine and hip extensors prone to reveal subtle proximal weakness.
  • Place your resistance close to the distal joint (short lever) for an accurate strength assessment.
ADVICE

Pries Fingers At Palmar Crease To Detect IBM

  • Test distal forearm flexors by prying the patient's fingers at the first palmar crease rather than standard grip strength.
  • This uncovers early finger‑flexor weakness typical of inclusion body myositis.
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