A 64-year-old man presents to the clinic because he is experiencing generalized weakness. He notes difficulty getting out of a chair, and lifting objects above his head as examples of the muscle weakness. He has lost 15 lb and feels unwell. On physical examination, there is a blue purple rash on his eyelids and knuckles, and muscle strength in his proximal muscles is rated 4 out of 5. His laboratory investigations are abnormal for an elevated creatinine kinase (CK) level. He is started on prednisone therapy. Which of the following is the most important in monitoring response to therapy?
The goal of therapy is to increase muscle strength and function, so following muscle strength is the key clinical assessment of response to therapy. The course of muscle necrosis in dermatomyositis can also be followed by repeated CK determinations. Repeated muscle biopsies or EMGs are rarely required.
testing of muscle strength
sedimentation rates
urine transaminase enzymes
EMG
Immunology and Rheumatology