MBBS OSCE · General Medicine
OSCE — Dermatomyositis & Polymyositis (Idiopathic Inflammatory Myopathies)
Eight-minute OSCE station on Dermatomyositis & Polymyositis (Idiopathic Inflammatory Myopathies): focused history, examination priorities, investigations, emergency and definitive management.
On this page
Study tools
Exam tags
Brief (to candidate)
You will assess a patient with a presentation consistent with Dermatomyositis & Polymyositis (Idiopathic Inflammatory Myopathies).
You have 8 minutes to take a focused history, outline examination, investigations, and management including red flags.
Clinical context
Idiopathic inflammatory myopathies (IIM) are acquired autoimmune muscle diseases causing symmetric, proximal muscle weakness (difficulty combing hair, rising from a chair, climbing stairs) with raised creatine kinase. Dermatomyositis (DM) features characteristic skin manifestations (heliotrope rash — violaceous periorbital; Gottron papules/sign — over knuckles; shawl/V-sign, nailfold changes); polymyositis (PM) is muscle-only. Other IIM: inclusion body myositis (IBM) (older, distal + quadriceps/finger flexor weakness, poor steroid response), immune-mediated necrotising myopathy (IMNM) (anti-SRP/HMGCR), antisynthetase syndrome (anti-Jo-1, ILD, fever, mechanic's hands, arthritis), juvenile DM.
Candidate tasks
- Clarify onset, severity, associated features, and red-flag symptoms.
- State focused examination priorities.
- List first-line investigations and any named score/criteria.
- Give immediate resuscitation steps.
- Outline definitive management with doses/routes where standard.
- Name complications and disposition (ward / HDU / theatre / discharge safety-net).
- Mention one special-population modifier (pregnancy, child, elderly, CKD).
Examiner checklist
| Domain | Pass behaviours |
|---|---|
| Definition | Correct working diagnosis language |
| Assessment | Focused, prioritised, red flags sought |
| Investigations | Appropriate first-line + interpretation |
| Emergency care | ABC / time-critical actions first |
| Definitive care | Specific drugs/procedures, not generic phrases |
| Safety | Symmetric proximal muscle weakness with markedly raised creatine kinase — inflam |
| Safety | Heliotrope rash or Gottron papules with proximal weakness — dermatomyositis; scr |
| Safety | Dermatomyositis in an adult — occult malignancy workup (age-appropriate plus ant |
| Communication | Clear plan and safety-netting |
Model outline
Lead with the working diagnosis and life threats. Resuscitate before definitive tests when unstable. Use guideline-standard therapy with named agents and doses. Document escalation criteria and follow-up. A safe candidate is specific, structured, and never delays critical care for non-urgent imaging.