Which feature helps distinguish polymyositis from polymyalgia rheumatica?

Which feature helps distinguish polymyositis from polymyalgia rheumatica?

• A. Proximal muscle weakness
• B. Intermittent joint swelling
• C. Skin rash
• D. Ophthalmoplegia

Answer: (A)

Proximal muscle weakness points to a primary myopathy rather than joint-related disease. In polymyositis, the immune attack targets skeletal muscle fibers, leading to true, symmetric weakness of proximal muscles (your shoulders, hips, and thighs) and difficulty with activities like rising from a chair or climbing stairs. In polymyalgia rheumatica, the issue is inflammatory pain and stiffness around the shoulder and hip girdles, but muscle strength is usually preserved; patients have prominent morning stiffness and difficulty with movement due to pain rather than true weakness. Skin rash would suggest dermatomyositis rather than polymyositis, and ophthalmoplegia isn’t a defining feature of these two conditions. So the presence of proximal muscle weakness best distinguishes polymyositis from polymyalgia rheumatica.

Proximal muscle weakness points to a primary myopathy rather than joint-related disease. In polymyositis, the immune attack targets skeletal muscle fibers, leading to true, symmetric weakness of proximal muscles (your shoulders, hips, and thighs) and difficulty with activities like rising from a chair or climbing stairs. In polymyalgia rheumatica, the issue is inflammatory pain and stiffness around the shoulder and hip girdles, but muscle strength is usually preserved; patients have prominent morning stiffness and difficulty with movement due to pain rather than true weakness. Skin rash would suggest dermatomyositis rather than polymyositis, and ophthalmoplegia isn’t a defining feature of these two conditions. So the presence of proximal muscle weakness best distinguishes polymyositis from polymyalgia rheumatica.