- Is the most common primary myopathy in the elderly manifesting as a slowly progressive weakness,
- Usually affecting finger and wrist flexion initially (but does affect both proximal and distal muscles).
- Lower limb weakness may also occur with quadriceps.
- In upper and lower limbs flexors affected more than extensors.
- Reflexes are usually diminished as in other myopathies.
- Creatine kinase levels are usually normal or only mildly raised, in contrast to polymyositis (where creatine kinase levels are usually markedly elevated).
- Associated with cytoplasmic inclusions on muscle biopsy. Muscles are often tender in polymyositis, the distal muscles are usually not affected until the disease is advanced and CK is significantly raised. Diabetic amyotrophy is characterized by painful wasting of the proximal lower limb muscles.
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