When would you suspect metabolic myopathy and what is your approach to initial workup?

Great question and really important to rheumatology practice. As always, a history and physical exam is the best initial diagnostic tool. It’s a little bit difficult because of the sheer number and heterogeneity of non-autoimmune myopathies that clinicians may encounter, but a few general principles...

The response by Dr. @Dr. First Last is excellent and nicely details all-important findings. I have a practical approach that I use in the clinic:

Suspect Metabolic Myopathy or Muscle Dystrophy if the answer is Yes to some or all of these. If yes, I would first do genetic testing of blood/saliva of n...