[Muscle diseases in an internal medicine department].
OBJECTIVE
(1) To describe the causes of muscular symptoms in patients undergoing a muscle biopsy in an internal medicine department; (2) to evaluate the diagnostic value of electromyography (EMG), CPK level and muscle biopsy.


METHODS
A retrospective study including 90 patients from June 1995 to March 2001.


RESULTS
The diagnosis were: inflammatory diseases (n = 35), non-organic (n = 24), peripheral neuropathy (n = 8), undetermined organic diseases (n = 7), metabolic diseases (n = 5), toxic diseases (n = 4), infectious diseases (n = 4), amyloidosis (n = 3). Diagnosis value of EMG, CPK and biopsy for organicity were: sensibility: 82%, 47% and 29%; specificity: 46%, 91%, 100%; positive predictive value: 78%, 94% and 100%; negative predictive value: 50%, 40% and 36%. Muscle biopsy is always normal when CPK and EMG are normal. It allows a diagnosis in one out of three cases if EMG and CPK are differing. It is also indicated when CPK are normal and EMG is myogenic.


CONCLUSIONS
Numerous diseases account for muscular symptoms. The low rate of diagnostic muscle biopsy imposes a comprehensive clinical approach of the patient and justify the implication of internal medicine physicians in his care. Early intervention of a psychosomatic medicine practitioner in the diagnostic procedure should be evaluated to diminish the number of non-contributory biopsies.
Chauvet
E
E
Service de médecine interne, place Baylac, pavillon des médecines, CHU Purpan, TSA 40031, 31059 Toulouse 9, France. miquelo@free.fr
Sailler
L
L
Madaule
S
S
Astudillo
L
L
Delisle
M-B
MB
Arne-Bes
M-C
MC
Megnin
Y
Y
Arlet
P
P
D003402:Creatine Kinase / Q000097:blood; D004576:Electromyography; D005260:Female; D006801:Humans; D007388:Internal Medicine; D008297:Male; D008875:Middle Aged; D009135:Muscular Diseases / Q000097:blood / Q000175:diagnosis*; D012189:Retrospective Studies; D012680:Sensitivity and Specificity
D003402:Creatine Kinase