Present status of cortisone myopathy]

Steroid myopathy is one of the various side effects of prolonged treatments, particularly with the 9 alpha fluorinated steroids. The receptor protein probably plays a major role with a decrease in protein synthesis. There is no mean to detect this myopathy before clinical signs appear. Neither muscular testing nor enzymes nor electromyography give arguments and muscular biopsy is aggressive. Low density scanner and MNR could help diagnosis. Frequency of disease is not known. A total cumulative maintenance steroid dosage of 400 mg can be sufficient. Proximal muscles are usually involved, quadriceps and other pelvic girdle muscles being more severely affected. Fast twitch glycolytic type IIB fibers are particularly susceptible. Physical exercise is effective in preventing myopathy. Nevertheless, no special rehabilitation program has been tested for the moment in human beings.