Asymmetrical scapular winging, bilateral facial muscle involvement and distal myopathy with normal CPK; unusual features in anti JO-I positive polymyositis

Abstract

Introduction Polymyositis is an idiopathic inflammatory myopathy which present with typical symmetrical proximal muscle weakness with the evidence of muscle inflammation. The acute inflammation of muscle results in high levels of CPK and has a relapsing remitting course with a good response to anti-inflammatory treatment. We present here a patient presented with a chronic myopathy with relapsing remitting fashion, with asymmetrical scapula winging, and bilateral facial weakness, with predominant distal muscle weakness which was supported by EMG.