12. Are we there Yet?

  1. James C. Pile8,
  2. Thomas E. Baudendistel9 and
  3. Brian J. Harte10
  1. Lisa H. Williams1,
  2. Gregory J. Raugi1,
  3. Gurpreet Dhaliwal2,3,
  4. Sanjay Saint4,5,6,7 and
  5. Benjamin A. Lipsky1

Published Online: 21 MAR 2013

DOI: 10.1002/9781118483206.ch12

Clinical Care Conundrums: Challenging Diagnoses in Hospital Medicine

Clinical Care Conundrums: Challenging Diagnoses in Hospital Medicine

How to Cite

Williams, L. H., Raugi, G. J., Dhaliwal, G., Saint, S. and Lipsky, B. A. (2013) Are we there Yet?, in Clinical Care Conundrums: Challenging Diagnoses in Hospital Medicine (eds J. C. Pile, T. E. Baudendistel and B. J. Harte), John Wiley & Sons, Inc., Hoboken, NJ, USA. doi: 10.1002/9781118483206.ch12

Editor Information

  1. 8

    Departments of Hospital Medicine and Infectious Diseases, Cleveland Clinic, Cleveland, Ohio, USA

  2. 9

    Department of Medicine, Kaiser Permanente Medical Center, Oakland, California, USA

  3. 10

    South Pointe Hospital, Cleveland Clinic Health System, Warrensville Heights, Ohio, USA

Author Information

  1. 1

    Primary and Specialty Medicine Service, Veterans Affairs Puget Sound Health Care System, Department of Medicine, The University of Washington School of Medicine, Seattle, Washington, USA

  2. 2

    Department of Medicine, University of California, San Francisco, California, USA

  3. 3

    Medical Service, San Francisco VA Medical Center, San Francisco, California, USA

  4. 4

    Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan, USA

  5. 5

    Ann Arbor VA Health Services Research and Development Field Program, Ann Arbor, Michigan, USA

  6. 6

    Patient Safety Enhancement Program, University of Michigan Health System, Ann Arbor, Michigan, USA

  7. 7

    Tuscan-American Safety Collaborative, Florence, Italy

Publication History

  1. Published Online: 21 MAR 2013
  2. Published Print: 15 MAR 2013

Book Series:

  1. Hospital Medicine: Current Concepts

Book Series Editors:

  1. Scott A. Flanders and
  2. Sanjay Saint

ISBN Information

Print ISBN: 9780470905654

Online ISBN: 9781118483206



  • cancers;
  • dermatomyositis;
  • endoscopy;
  • infection;
  • malignancy screening


The diagnosis of dermatomyositis may be challenging, given the absence of a “gold standard” test. A combination of clinical, laboratory, biopsy, and electromyographic data may need to be considered to arrive at the diagnosis. Ovarian, lung, gastric, colorectal, pancreatic, and breast carcinomas, as well as non- Hodgkin's lymphoma, are the most common cancers associated with dermatomyositis. In addition to age-appropriate cancer screening, one should consider obtaining upper endoscopy, imaging chest/abdomen/pelvis, and a serum CA-125 test in patients. Patients with dermatomyositis and no obvious concurrent malignancy need long-term outpatient follow-up for repeated malignancy screening.