Dermatomyositis: evolution of a diagnosis

Area of Science:

• Rheumatology
• Dermatology
• Physical Therapy

Background:

• Direct access in physical therapy necessitates recognizing systemic conditions.
• Physical therapists are increasingly encountering patients with complex pathologies.

Observation:

• An 18-year-old woman presented with multiple musculoskeletal diagnoses over time.
• The physical therapist noted signs suggestive of dermatologic disease during the third referral.

Findings:

• The patient was diagnosed with dermatomyositis by a rheumatologist.
• Physical therapy focused on strengthening, stretching, and a home exercise program.
• The patient showed consistent functional improvements over 18 months, measured by SF-36.

Implications:

• Physical therapists play a crucial role in identifying systemic diseases beyond their direct scope.
• This case highlights the importance of the diagnostic process in physical therapy for uncovering underlying conditions.
• Early recognition by physical therapists can lead to timely diagnosis and appropriate management of inflammatory myopathies.