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 Best of Five 2.116

 

   

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BOF: 2.116

A 58-year-old male presents with a history of falls and difficulty in performing common tasks like opening doors.

He also gives a history of choking when he eats.

The history is of several months duration and he feels the problems are steadily getting worse

There is no other significant history, no family history of note and he is not on any regular medication.

On examination you note weakness of the muscles of his shoulder and pelvic girdle and distal weakness, especially affecting the finger flexors.

There is asymmetric wasting of the muscles. Tendon reflexes are preserved.

There is no sensory deficit.

In this patient the most likely diagnosis is:

a)      Polymyositis

b)      Dermatomyositis

c)      Inclusion body myositis

d)      Amyotrophic lateral sclerosis

e)      Syringomyelia

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