When should I consider referring a patient with suspected polymyositis

Guideline-aligned answer with reasoning, red flags and references. Clinically reviewed by Dr Kola Tytler MBBS CertHE MBA MRCGP.

For a patient with suspected polymyositis, consider referral based on the nature and progression of their symptoms:

Slowly Progressive Weakness: For adults with slowly (within weeks to months) progressive limb or neck weakness, refer for an assessment for neuromuscular disorders .
Urgent Symptoms:
- Refer urgently if there is any evidence of swallowing impairment .
- Refer immediately if there is breathlessness at rest or when lying flat .
Uncertain Diagnosis: If the diagnosis is uncertain, consider referring to an appropriate specialist, such as a rheumatologist, neurologist, or other musculoskeletal specialist .
Underlying Cause of Tiredness/Fatigue: If there is a suspected or confirmed underlying cause for tiredness/fatigue that cannot be managed in primary care, arrange referral to an appropriate secondary care specialist .

When should I consider referring a patient with suspected polymyositis to a specialist?