Hypocalcaemia - Osteomalacia |
- Muscle weakness
- Bone pain
- Difficulty rising from a chair
|
- Calcium, Phosphate
- Vitamin D levels
- Alkaline Phosphatase (ALP)
|
- Calcium and Vitamin D supplementation
- Address underlying cause of hypocalcaemia
|
Thyroid Disease (Hyper/Hypothyroidism) |
- Muscle weakness
- Fatigue
- Weight changes, tremors (hyper) or sluggishness (hypo)
|
- Thyroid Function Tests (TFTs)
|
- Treat thyroid disorder (thyroxine for hypothyroidism, antithyroid drugs for hyperthyroidism)
|
Steroid Use - Cushing's Syndrome |
- Proximal muscle weakness
- Weight gain, easy bruising
- Facial rounding, striae
|
- 24-hour urinary cortisol
- Dexamethasone suppression test
|
- Reduce or taper steroid dosage (if possible)
- Treat Cushing’s syndrome surgically or medically
|
Myositis (e.g., due to statins) |
- Muscle pain or tenderness
- Weakness in the thighs and shoulders
|
- Creatine Kinase (CK)
- Autoimmune antibodies (in case of polymyositis)
|
- Discontinue or switch statins
- Consider immunosuppressive therapy for inflammatory causes
|
Polymyositis |
- Progressive muscle weakness
- Difficulty with climbing stairs, lifting objects
|
- Creatine Kinase (CK)
- Muscle biopsy
- Autoimmune panel
|
- Corticosteroids
- Immunosuppressive medications
- Physiotherapy
|
Myasthenia Gravis |
- Fatigable muscle weakness
- Ptosis, diplopia
- Difficulty swallowing, breathing
|
- Acetylcholine receptor antibodies
- Electromyography (EMG)
|
- Acetylcholinesterase inhibitors
- Immunosuppressive therapy
- Thymectomy (if indicated)
|