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proximal muscle weakness
Weakness of muscles controlling movement of the hip & shoulder.
Etiology:
1) osteomalacia
2) dermatomyositis
3) polymyositis (rapidly progressive)
4) Lambert-Eaton syndrome
5) Cushing's syndrome
6) hypothyroidism (late manifestation)
7) hyperthyroidism
8) hyperparathyroidism
9) vitamin D deficiency
10) colchicine
11) long-term glucocorticoid [3]
* if both proximal muscle weakness & distal muscle weakness, consider inclusion body myositis
Clinical manifestations:
- bilateral proximal muscle weakness suggests myopathy
* impaired effort & strength in deltoids & hip flexors secondary to pain does not constitute proximal muscle weakness [2]
Differential diagnosis:
- polymyalgia rheumatica
- bilateral shoulder pain, neck pain & hip pain that may be described as impaired effort & strength in deltoids & hip flexors secondary to pain [2]
General
muscle weakness
References
- Medical Knowledge Self Assessment Program (MKSAP) 15,
American College of Physicians, Philadelphia 2009
- Geriatric Review Syllabus, 8th edition (GRS8)
Durso SC and Sullivan GN (eds)
American Geriatrics Society, 2013
- Geriatric Review Syllabus, 11th edition (GRS11)
Harper GM, Lyons WL, Potter JF (eds)
American Geriatrics Society, 2022
- NEJM Knowledge+ Complex Medical Care