RhAPPcast: Cracking the Code: A Rheum Derm Neuro Multispecialty Case Approach to Myositis

In this episode of RhAPPcast, the official podcast of Rheumatology Advanced Practice Providers, host Amanda Mixon leads a multidisciplinary, case-based discussion titled “Cracking the Code: A Rheum-Derm-Neuro Multispecialty Case Approach to Myositis.” Joined by dermatology clinician Laura Bush and neuromuscular medicine PA Maggie Naclerio, this episode explores the complex and often subtle presentations of myositis, idiopathic inflammatory myopathies, dermatomyositis, immune-mediated necrotizing myopathy, and inclusion body myositis. Through real-world clinical cases, the conversation highlights how patients may first present with skin findings, proximal muscle weakness, falls, elevated CK levels, hoarseness, interstitial lung disease concerns, or atypical symptoms that can delay diagnosis. Listeners will gain practical insight into recognizing key myositis signs such as Gottron’s papules, heliotrope rash, shawl sign, holster sign, nailfold capillary changes, limb-girdle weakness, and functional decline, while also learning how dermatology, rheumatology, neurology, primary care, and pulmonology can collaborate to improve outcomes. The episode also covers important diagnostic tools and clinical pearls, including myositis antibody panels, CK trending, aldolase, ESR, CRP, thyroid testing, EMG, MRI, muscle biopsy, HMGCR antibodies, MDA5-associated disease, malignancy risk, false-positive antibody testing, and the importance of a high-quality physical exam. Designed for rheumatology APPs, physician assistants, nurse practitioners, dermatology clinicians, neurology providers, and all healthcare professionals caring for patients with autoimmune muscle disease, this episode emphasizes earlier recognition, better specialty coordination, and individualized treatment strategies for patients living with myositis. Subscribe to RhAPPcast for more rheumatology education, clinical insights, and practical updates from the RhAPP community.