Myopathien, Myositiden, Vaskulitiden mit Muskelbeteiligung

Abstract

Muscle and nerve biopsies provide valuable information contributing to the diagnosis of diseases of the peripheral nervous system and skeletal muscle. The application of modern histological, immunohistochemical, electron microscopic and molecular methods establishes a definite diagnosis in many cases and narrows the spectrum of possible entities in most of the remaining cases. Inflammatory myopathies and neuropathies are distinguished from non-inflammatory muscular and peripheral nervous conditions. The latter include muscular dystrophies and congenital myopathies, hereditary neuropathies, metabolic diseases affecting skeletal muscle and peripheral nerves as well as degenerative myopathies and neuropathies including sporadic motor neuron diseases.

Stepwise Approach to Myopathy in Systemic Disease

“…A successful clinical approach to a patient with a suspected myopathy is based on a thorough medical history and neurological examination (Srinivasan and Amato, 2003; Jackson, 2008; Weis and Nolte, 2009; Selcen, 2011). The following systemic symptoms and signs are extremely helpful in narrowing the differential diagnosis.…”

“…Understanding of the prior steps is essential as how to approach your next patient with muscle weakness and helps you identify a pattern of the disease (Srinivasan and Amato, 2003; Weis and Nolte, 2009; Marie, 2011; Selcen, 2011). The differential diagnosis of any systemic myopathy (please also see Table 1) should include the following:…”