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Time again for #NeuromuscularQandA? RT. #neurology #medtwitter #MedEd #medstudent #neurologyresident Join me in discussing/learning/educating with #passion and #humor @WNGtweets @MedTweetorials @MadSattinJ @NinaRiggins @AaronLBerkowitz @Tracey1milligan
Q. What up doc. My #IBM patient doesn’t have #NT51a antibodies and my #SLE patient has #NT51a antibodies. I’m confused.
A: If only life wasn’t messy. 30 percent of #IBM patients don’t have #NT51a and false positives happen with #SLE and #Sjogrens which can cause #overlapmyositis.
Q: Ah, does it matter doc?
A: If it changes management it does. #overlapmyositis is treatable and #IBM is not. Not now anyway #AcademicTwitter
Q: What to do then what to do?
A: Go old school. Check muscle biopsy for #rimmedvacuoles and #coxnegative fibers - those will point you the way of #IBM.
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#NeuromuscularQandA #neurology #medtwitter #MedEd #medstudent #neurologyresident #passion #humor #IBM #NT51a #SLE #Sjogrens #overlapmyositis #AcademicTwitter #rimmedvacuoles #coxnegative

More from @CrystalYeoMDPhD see all

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Crystal Yeo, MD PhD
@CrystalYeoMDPhD
Time again for #NeuromuscularQandA? RT. #neurology #medtwitter #MedEd #medstudent #neurologyresident Join me in discussing/learning/educating with #passion and #humor @WNGtweets @MonicaDhakar @MadSattinJ @NinaRiggins @AaronLBerkowitz @RachelSalasMD
Let’s have a philosophical discussion today. Q: Doc doc there are fibs and sharps everywhere on the EMG! Arms, legs, thoracic and lumbar paraspinals. NCS normal. What could it be?
A: Ah, widespread muscle membrane instability. Could be neurogenic, could be myopathic. What’s the recruitment like? Remember reduced recruitment in neurogenic and normal or rapid in myopathic.
Read 11 tweets
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Crystal Yeo, MD PhD
@CrystalYeoMDPhD
Time again for #NeuromuscularQandA? RT. #neurology #medtwitter #MedEd #medstudent #neurologyresident Join me in discussing/learning/educating with #passion and #humor @WNGtweets @neurobickel @MadSattinJ @NinaRiggins @AaronLBerkowitz @RachelSalasMD
Q: Doc, doc, got a patient with CIDP. He wants to know when he can be off IVIG. He’s a gambling man, that he is. Wants to take his chances. #MedStudentTwitter #MedEd #AcademicTwitter
A: Game theory time! Naw, let’s see if we can answer it by closely looking at studies. Or just one. Check out the ICE study in 2008 and see if you can spot Wally. #meded
Read 7 tweets
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Crystal Yeo, MD PhD
@CrystalYeoMDPhD
Now eye enjoyed an important question addressed at #EAN2020. Good to think about when you are called to ED for #opticneuritis. Let’s think about it together. Let’s focus on #clinicaldiagnosismaking #meded #medstudenttwitter #medtwitter #neurologyresident @WNGtweets @EANeurology
How do you tell if it’s optic neuritis or not? #painless #unilateral #altitudinal -means top half or bottom half of the field - vision loss more likely to be non-arteritic AION. Any other red flags less likely to be optic neuritis?
Now if it’s #painful it’s more likely #opticneuritis - but what sort? Bilateral vision loss and painful, think #MOG. Unilateral severe vision loss more than pain, think #Aquaporin4. MRI orbits show longitudinal extensive optic nerve enhancement in both. So MRI orbits for clues.
Read 8 tweets

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