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

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 ¹.
• Urgent Symptoms:
  • Refer urgently if there is any evidence of swallowing impairment ¹.
  • Refer immediately if there is breathlessness at rest or when lying flat ¹.
• Uncertain Diagnosis: If the diagnosis is uncertain, consider referring to an appropriate specialist, such as a rheumatologist, neurologist, or other musculoskeletal specialist ².
• 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 ³.