A 45-year-old woman presents to the physician with a 3-month history of general weakness, myalgia, and fatigue. She describes progressive muscle weakness of the upper and lower extremities. She reports having traveled to Costa Rica three months ago. Physical examination shows a palpable left adnexal mass not present during her last examination one year ago. A muscle biopsy of the right vastus medialis is performed and shown below.
What’s the most likely diagnosis?
Brody myopathy
Facioscapulohumeral muscular dystrophy
Paraneoplastic necrotizing myopathy
Polymyalgia rheumatica
Polymyositis
Tropical spastic paraparesis
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Cut-to-the-chase Answer (0:56):
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HY USMLE Answer (7:26):
