Inclusion body myositis: a case of bilateral extremity weakness.

[inclusion body myositis]

Inflammatory myopathy is a common cause of bilateral muscular weakness in adults . Although not as common as polymyositis , inclusion body myositis (IBM ) is a form of inflammatory myopathy characterized by chronic progressive muscle inflammation and often goes undiagnosed and untreated . IBM patients most commonly present with proximal lower extremity weakness and may have normal creatine kinase (CK ) levels . A high level of clinical suspicion is required for prompt and accurate diagnosis of IBM , which is diagnosed definitively with a muscle biopsy . The patient described in this case report is a 68 -year -old man who initially presented with both bilateral symmetric proximal lower extremity and distal upper extremity weakness . IBM was suspected through history , electromyography , and definitively diagnosed with muscle biopsy . The patient was subsequently initiated on prednisone therapy and physical therapy , with improvement in muscular strength after 2 months . In patients presenting with bilateral extremity weakness and normal CK level , the diagnosis of IBM should be included in the differential diagnosis and muscle biopsy performed for appropriate cases .