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| '''Neurogenic''' | | '''Neurogenic''' | ||
| '''Myogenic''' | | '''Myogenic''' | ||
| | | Notes | ||
| | | Image | ||
|- | |- | ||
| Shape of fibres | | Shape of fibres | ||
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*Rimmed vacuoles = inclusion body myositis. | *Rimmed vacuoles = inclusion body myositis. | ||
*PAS +++ = glycogen storage disease. | *PAS +++ = glycogen storage disease. | ||
*Regenerative fibres = large nuclei, basophilic cytoplasm (incr. protein synthesis, incr. RNA). | |||
===Approach=== | ===Approach=== | ||
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===General=== | ===General=== | ||
*Complement mediated disease... membrane attach complex. | *Complement mediated disease... membrane attach complex. | ||
*Usually middle age. (???) | |||
*Associated skin rash is common. (???) | |||
===Microscopic=== | ===Microscopic=== | ||
Features: | Features: | ||
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==Inclusion body myositis== | ==Inclusion body myositis== | ||
===General=== | |||
*Usually elderly. | |||
===Microscopic=== | ===Microscopic=== | ||
Features: | Features: | ||
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===General=== | ===General=== | ||
*Tx: steroids. | *Tx: steroids. | ||
===Microscopic=== | ===Microscopic=== | ||
Features: | Features: | ||
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==Muscular dystrophy== | ==Muscular dystrophy== | ||
===General=== | ===General=== | ||
*DDx: | *DDx: large. | ||
===Microscopic=== | ===Microscopic=== | ||
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*Endomysial fibrosis. | *Endomysial fibrosis. | ||
*Hypercontracted fibres (large muscle fibres). | *Hypercontracted fibres (large muscle fibres). | ||
==Myotonic dystrophy== | |||
===Microscopic=== | |||
Features: | |||
*Internal nuclei/central nuclei. | |||
==Nemaline myopathy== | |||
===General=== | |||
*A type of congenital myopathy. | |||
*Paediatric thingy. | |||
==Mitochondrial disorders== | |||
===General=== | |||
*Onset childhood to adulthood. | |||
*Heteroplasmy - variable distribution of badness within affected individuals. | |||
**Leads to "threshold effect". | |||
===Microscopic=== | |||
*Trichrome most useful - find the ragged red fibres - usu. at the cell periphery. | |||
*COX-SDH - non-staining. | |||
==Type 2 fibre atrophy== | |||
DDx: | |||
*Disuse. | |||
*Space travel. | |||
*Steroids. | |||
*Others. | |||
==Nerve stuff== | |||
===General=== | |||
*Biopsy: sural nerve. | |||
*Myelin stain: blue = myelin. | |||
*Gomori trichrome: axon = green, myelin = red. | |||
==See also== | |||
*[[Neuropathology]]. | |||
==References== | ==References== |
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