Myositis – Grade 1

Management escalation pathway

• In case of doubt withhold ICPI
• Initiate paracetamol/NSAID
• If symptom severity increases despite NSAID consider treatment cfr grade 2
• Control CK after one week, if increasing: discuss with local myositis specialist

Assessment and Investigations

• Complete history of all organ systems
• Perform examination of joints and skin
• Exclude cardiac origin (CKMB/troponin/pro-BNP and ECG) and in case of doubt perform cardiac MRI
• ! Troponin I is more specific of cardiac involvement than troponin T
• Exclude other causes of elevated CK: IM injection, physical activity, …