Inclusion Body Myositis and Statin Induced Myopathy: A Case Report of Back Pain and Progressive Lower Extremity Weakness

Saturday, October 25, 2025

8:00 AM - 9:15 AM MT

Location: Kiosk 1

Poster Presenter(s)

Stefan Hamaway, MD

Resident Physician
State University of New York (SUNY) Downstate Health Sciences Univ PM&R Program
Old Westbury, New York

Co-Author(s)

Ajit Kohli, DO

Resident Physician
State University of New York (SUNY) Downstate Health Sciences Univ PM&R Program
Brooklyn, New York
Brandon Amirian, MD

Resident Physician
State University of New York (SUNY) Downstate Health Sciences Univ PM&R Program
Brooklyn, New York
SA

Sanjeev Agarwal, MD

Program Director
SUNY Downstate Health Sciences University
Brooklyn, New York

Disclosure(s):

Stefan Hamaway, MD: No financial relationships to disclose

Ajit Kohli, DO: No financial relationships to disclose

Brandon Amirian, MD: No financial relationships to disclose

Sanjeev Agarwal, MD: No financial relationships to disclose

Case Diagnosis: Rehabilitation of patient presenting with both IBM and statin induced myopathy.

Case Description or Program Description: 88 year old male with PMH of HTN, HLD, CAD, OSA was recently diagnosed with both inclusion body myositis and statin induced myopathy after admission 4 months prior for progressive proximal lower extremity weakness with difficulty rising from a seated position. He had an MRI of the thighs showing mild bilateral intramuscular edema, more pronounced proximally raising concern for myositis. Labwork was significant for elevated CK, and positive Anti-HMGCR and Anti-NT5c1a antibodies. EMG showed evidence of an acute on chronic myopathic process affecting distal and proximal muscles with presence of complex regional discharges and muscle biopsy was done showing myopathic changes with rimmed vacuoles. Patient was then discharged to subacute rehabilitation. On initial physical exam with physiatrist, patient had proximal lower extremity weakness 3/5 and was started on a course of physical and occupational therapy.

Setting: Subacute Rehabilitation center

Assessment/Results: Patient completed steroid taper during therapy course. On follow up evaluation 2 months later, strength was noted to improve to 4/5 over bilateral hip flexors and he was able to perform transfers modified independent with straight cane and ambulate with a rollator. Bathroom and home modifications were recommended and completed so patient can have improved accessibility entering his home and for toileting and bathing to ensure safe discharge planning back home.

Discussion (relevance): This is a rare case of a patient presenting with both inclusion body myositis and statin induced myopathy for progressive lower extremity weakness requiring both rehabilitation as well as home modifications to reduce morbidity.

Conclusions: This case emphasizes the holistic approach a skilled physiatrist should take to provide well-rounded care for patients with myositis and myopathy including patient education, managing expectations, and assessing for adaptations and modifications that can be done to reduce disability and improve patient independence.