{"id":315,"date":"2025-03-08T21:32:21","date_gmt":"2025-03-08T21:32:21","guid":{"rendered":"https:\/\/rheumanext.pl\/?page_id=315"},"modified":"2026-03-14T19:23:24","modified_gmt":"2026-03-14T19:23:24","slug":"zapalenie-wielomiesniowe-oraz-skorno-miesniowe-wg-bohana-i-petera","status":"publish","type":"page","link":"https:\/\/rheumanext.pl\/en\/kalkulatory\/kryteria\/zapalenie-wielomiesniowe-oraz-skorno-miesniowe-wg-bohana-i-petera\/","title":{"rendered":"Zapalenie wielomi\u0119\u015bniowe (PM) oraz zapalenie sk\u00f3rno-mi\u0119\u015bniowe (DM) &#8211; wg Bohana i Petera"},"content":{"rendered":"<section id=\"rx-bohan-peter-pmdm-calculator\" style=\"max-width:960px;margin:0 auto;font:16px\/1.55 Inter,ui-sans-serif,system-ui,-apple-system,BlinkMacSystemFont,'Segoe UI',sans-serif;color:#0f172a;\">\n  <div style=\"background:linear-gradient(180deg,#ffffff 0%,#fbfdff 100%);border:1px solid #e2e8f0;border-radius:24px;box-shadow:0 12px 30px rgba(15,23,42,.06);overflow:hidden;\">\n    <div style=\"padding:28px 28px 20px;border-bottom:1px solid #e2e8f0;background:radial-gradient(circle at top right, rgba(15,118,110,.08), transparent 32%), linear-gradient(180deg,#ffffff 0%,#f8fafc 100%);\">\n      <div style=\"display:inline-block;padding:6px 12px;border-radius:999px;background:rgba(15,118,110,.10);color:#0f766e;font-size:12px;font-weight:700;letter-spacing:.02em;text-transform:uppercase;margin-bottom:14px;\">Kalkulator klasyfikacyjny<\/div>\n      <h2 style=\"margin:0 0 10px;font-size:clamp(24px,3vw,32px);line-height:1.15;letter-spacing:-.02em;\">Zapalenie wielomi\u0119\u015bniowe (PM) oraz zapalenie sk\u00f3rno-mi\u0119\u015bniowe (DM) \u2014 Bohan i Peter<\/h2>\n      <p style=\"margin:0;color:#475569;max-width:76ch;\">Po wykluczeniu innych miopatii oceniane s\u0105 4 kryteria mi\u0119\u015bniowe. Typowa osutka sk\u00f3rna przesuwa klasyfikacj\u0119 w stron\u0119 dermatomyositis (DM); jej brak przemawia za polymyositis (PM).<\/p>\n    <\/div>\n\n    <div style=\"padding:28px;display:grid;gap:20px;\">\n      <div style=\"background:#fff;border:1px solid #e2e8f0;border-radius:20px;padding:20px;\">\n        <h3 style=\"margin:0 0 6px;font-size:18px;\">1. Zastosowanie kryteri\u00f3w<\/h3>\n        <p style=\"margin:0 0 16px;color:#475569;font-size:14px;\">Najpierw oce\u0144, czy inne miopatie i rozpoznania alternatywne zosta\u0142y wystarczaj\u0105co wykluczone.<\/p>\n\n        <label style=\"display:flex;align-items:flex-start;gap:10px;padding:12px 14px;border:1px solid #e2e8f0;border-radius:16px;margin-bottom:10px;background:#fff;cursor:pointer;\">\n          <input type=\"radio\" name=\"rx-bp-entry\" id=\"rx-bp-entry-no\" value=\"no\" checked style=\"margin-top:3px;accent-color:#0f766e;\">\n          <span><strong>Nie<\/strong><br><span style=\"color:#475569;font-size:13px;\">inne miopatie \/ lepsze rozpoznanie nie zosta\u0142y wykluczone<\/span><\/span>\n        <\/label>\n\n        <label style=\"display:flex;align-items:flex-start;gap:10px;padding:12px 14px;border:1px solid #e2e8f0;border-radius:16px;background:#fff;cursor:pointer;\">\n          <input type=\"radio\" name=\"rx-bp-entry\" id=\"rx-bp-entry-yes\" value=\"yes\" style=\"margin-top:3px;accent-color:#0f766e;\">\n          <span><strong>Tak<\/strong><br><span style=\"color:#475569;font-size:13px;\">inne miopatie zosta\u0142y zasadnie wykluczone<\/span><\/span>\n        <\/label>\n      <\/div>\n\n      <div style=\"background:#fff;border:1px solid #e2e8f0;border-radius:20px;padding:20px;\">\n        <h3 style=\"margin:0 0 6px;font-size:18px;\">2. Typowa osutka sk\u00f3rna DM<\/h3>\n        <p style=\"margin:0 0 16px;color:#475569;font-size:14px;\">Je\u015bli obecna, kieruje klasyfikacj\u0119 w stron\u0119 dermatomyositis.<\/p>\n\n        <label style=\"display:flex;align-items:flex-start;gap:10px;padding:14px;border:1px solid #e2e8f0;border-radius:16px;background:#fff;cursor:pointer;\">\n          <input type=\"checkbox\" id=\"rx-bp-rash\" style=\"margin-top:3px;accent-color:#0f766e;\">\n          <span><strong>Typowa osutka sk\u00f3rna dla DM<\/strong><br><span style=\"color:#475569;font-size:13px;\">np. heliotrope rash, Gottron\u2019s papules \/ Gottron\u2019s sign<\/span><\/span>\n        <\/label>\n      <\/div>\n\n      <div style=\"background:#fff;border:1px solid #e2e8f0;border-radius:20px;padding:20px;\">\n        <h3 style=\"margin:0 0 6px;font-size:18px;\">3. Kryteria mi\u0119\u015bniowe<\/h3>\n        <p style=\"margin:0 0 16px;color:#475569;font-size:14px;\">Zaznacz wszystkie spe\u0142nione kryteria. Ka\u017cde liczy si\u0119 jako 1 kryterium mi\u0119\u015bniowe.<\/p>\n\n        <div style=\"display:grid;grid-template-columns:repeat(auto-fit,minmax(240px,1fr));gap:12px;\">\n          <label style=\"display:flex;align-items:flex-start;gap:10px;padding:14px;border:1px solid #e2e8f0;border-radius:16px;background:#fff;cursor:pointer;\">\n            <input type=\"checkbox\" id=\"rx-bp-weakness\" style=\"margin-top:3px;accent-color:#0f766e;\">\n            <span><strong>Symetryczne os\u0142abienie mi\u0119\u015bni proksymalnych<\/strong><br><span style=\"color:#475569;font-size:13px;\">zwykle post\u0119puj\u0105ce, w obr\u0119czy barkowej i\/lub miednicznej<\/span><\/span>\n          <\/label>\n\n          <label style=\"display:flex;align-items:flex-start;gap:10px;padding:14px;border:1px solid #e2e8f0;border-radius:16px;background:#fff;cursor:pointer;\">\n            <input type=\"checkbox\" id=\"rx-bp-enzymes\" style=\"margin-top:3px;accent-color:#0f766e;\">\n            <span><strong>Podwy\u017cszone enzymy mi\u0119\u015bniowe<\/strong><br><span style=\"color:#475569;font-size:13px;\">np. CK, aldolaza, AST, ALT, LDH<\/span><\/span>\n          <\/label>\n\n          <label style=\"display:flex;align-items:flex-start;gap:10px;padding:14px;border:1px solid #e2e8f0;border-radius:16px;background:#fff;cursor:pointer;\">\n            <input type=\"checkbox\" id=\"rx-bp-emg\" style=\"margin-top:3px;accent-color:#0f766e;\">\n            <span><strong>EMG miopatyczne<\/strong><br><span style=\"color:#475569;font-size:13px;\">typowe zmiany miogenne \/ dra\u017cliwo\u015b\u0107 b\u0142ony mi\u0119\u015bniowej<\/span><\/span>\n          <\/label>\n\n          <label style=\"display:flex;align-items:flex-start;gap:10px;padding:14px;border:1px solid #e2e8f0;border-radius:16px;background:#fff;cursor:pointer;\">\n            <input type=\"checkbox\" id=\"rx-bp-biopsy\" style=\"margin-top:3px;accent-color:#0f766e;\">\n            <span><strong>Biopsja mi\u0119\u015bnia zgodna z zapaleniem mi\u0119\u015bni<\/strong><br><span style=\"color:#475569;font-size:13px;\">cechy zapalne \/ martwica \/ regeneracja \/ nacieki kom\u00f3rkowe zgodne z myositis<\/span><\/span>\n          <\/label>\n        <\/div>\n      <\/div>\n\n      <div style=\"display:flex;flex-wrap:wrap;gap:12px;margin-top:2px;\">\n        <button\n          type=\"button\"\n          id=\"rx-bp-calc-btn\"\n          style=\"appearance:none;border:0;border-radius:16px;padding:14px 18px;background:linear-gradient(180deg,#0f766e 0%,#115e59 100%);color:#fff;font:inherit;font-weight:700;cursor:pointer;box-shadow:0 12px 24px rgba(15,118,110,.22);display:inline-flex;align-items:center;justify-content:center;min-width:180px;\"\n        >Oblicz wynik<\/button>\n\n        <button\n          type=\"button\"\n          id=\"rx-bp-clear-btn\"\n          style=\"appearance:none;border:1px solid #cbd5e1;border-radius:16px;padding:14px 18px;background:#fff;color:#0f172a;font:inherit;font-weight:700;cursor:pointer;display:inline-flex;align-items:center;justify-content:center;\"\n        >Wyczy\u015b\u0107<\/button>\n      <\/div>\n\n      <div id=\"rx-bp-result\" style=\"display:block;border-radius:20px;padding:20px;border:1px solid #e2e8f0;background:#f8fafc;\">\n        <p id=\"rx-bp-result-title\" style=\"margin:0 0 8px;font-size:18px;line-height:1.3;font-weight:800;color:#0f172a;\">Wynik pojawi si\u0119 tutaj<\/p>\n        <p id=\"rx-bp-result-text\" style=\"margin:0 0 8px;\">Zaznacz odpowiedzi, a nast\u0119pnie kliknij \u201eOblicz wynik\u201d.<\/p>\n        <p id=\"rx-bp-result-note\" style=\"margin:0;color:#475569;font-size:14px;\">Regu\u0142a: po wykluczeniu innych miopatii policz 4 kryteria mi\u0119\u015bniowe. Bez osutki klasyfikujesz PM; z typow\u0105 osutk\u0105 klasyfikujesz DM.<\/p>\n      <\/div>\n\n      <div style=\"border:1px solid #e2e8f0;background:linear-gradient(180deg,#ffffff 0%,#f8fafc 100%);border-radius:18px;padding:16px 18px;color:#475569;font-size:14px;\">\n        <strong style=\"color:#0f172a;\">Uwaga:<\/strong> to narz\u0119dzie wspiera klasyfikacj\u0119 PM\/DM wed\u0142ug klasycznych kryteri\u00f3w Bohana i Petera. Kryteria te nie obejmuj\u0105 dobrze wsp\u00f3\u0142cze\u015bnie wyr\u00f3\u017cnianych podtyp\u00f3w IIM ani postaci amyopatycznych. Edukacyjnie. Nie zast\u0119puje konsultacji lekarskiej.\n      <\/div>\n    <\/div>\n  <\/div>\n<\/section>\n\n<script>\n(function () {\n  var calcBtn = document.getElementById('rx-bp-calc-btn');\n  var clearBtn = document.getElementById('rx-bp-clear-btn');\n\n  if (!calcBtn || !clearBtn) return;\n\n  calcBtn.addEventListener('click', function () {\n    var entryMet = document.getElementById('rx-bp-entry-yes').checked;\n    var rash = document.getElementById('rx-bp-rash').checked;\n\n    var weakness = document.getElementById('rx-bp-weakness').checked;\n    var enzymes = document.getElementById('rx-bp-enzymes').checked;\n    var emg = document.getElementById('rx-bp-emg').checked;\n    var biopsy = document.getElementById('rx-bp-biopsy').checked;\n\n    var muscleCount = 0;\n    var muscleList = [];\n\n    if (weakness) {\n      muscleCount += 1;\n      muscleList.push('symetryczne os\u0142abienie mi\u0119\u015bni proksymalnych');\n    }\n    if (enzymes) {\n      muscleCount += 1;\n      muscleList.push('podwy\u017cszone enzymy mi\u0119\u015bniowe');\n    }\n    if (emg) {\n      muscleCount += 1;\n      muscleList.push('EMG miopatyczne');\n    }\n    if (biopsy) {\n      muscleCount += 1;\n      muscleList.push('biopsja mi\u0119\u015bnia zgodna z myositis');\n    }\n\n    var result = document.getElementById('rx-bp-result');\n    var title = document.getElementById('rx-bp-result-title');\n    var text = document.getElementById('rx-bp-result-text');\n    var note = document.getElementById('rx-bp-result-note');\n\n    result.style.display = 'block';\n\n    if (!entryMet) {\n      result.style.background = '#fef2f2';\n      result.style.border = '1px solid #fecaca';\n      title.style.color = '#991b1b';\n      title.innerHTML = 'Kryteria nie maj\u0105 zastosowania';\n      text.innerHTML = 'Klasyczne kryteria Bohana i Petera wymagaj\u0105 uprzedniego wykluczenia innych miopatii i lepszego rozpoznania alternatywnego.';\n      note.innerHTML = 'Najpierw wyklucz inne przyczyny miopatii, np. neurogenne, metaboliczne, endokrynologiczne, toksyczne lub dystrofie mi\u0119\u015bniowe.';\n      return;\n    }\n\n    var classification = '';\n    var certainty = '';\n    var phenotype = rash ? 'DM' : 'PM';\n\n    if (rash) {\n      if (muscleCount >= 3) {\n        classification = 'definite DM';\n        certainty = 'definite';\n      } else if (muscleCount === 2) {\n        classification = 'probable DM';\n        certainty = 'probable';\n      } else if (muscleCount === 1) {\n        classification = 'possible DM';\n        certainty = 'possible';\n      }\n    } else {\n      if (muscleCount >= 4) {\n        classification = 'definite PM';\n        certainty = 'definite';\n      } else if (muscleCount === 3) {\n        classification = 'probable PM';\n        certainty = 'probable';\n      } else if (muscleCount === 2) {\n        classification = 'possible PM';\n        certainty = 'possible';\n      }\n    }\n\n    if (classification) {\n      result.style.background = '#f0fdf4';\n      result.style.border = '1px solid #bbf7d0';\n      title.style.color = '#166534';\n      title.innerHTML = 'Kryteria spe\u0142nione';\n      text.innerHTML = 'Najbardziej zgodna klasyfikacja wg Bohana i Petera: <strong>' + classification + '<\/strong>.';\n      note.innerHTML = 'Osutka typowa dla DM: ' + (rash ? 'tak' : 'nie') + '. Spe\u0142nione kryteria mi\u0119\u015bniowe: ' + muscleCount + '\/4' + (muscleList.length ? ' \u2014 ' + muscleList.join(', ') + '.' : '.');\n      if (certainty === 'possible') {\n        note.innerHTML += ' Wynik odpowiada najni\u017cszemu poziomowi pewno\u015bci w tych kryteriach.';\n      }\n    } else {\n      result.style.background = '#fffbeb';\n      result.style.border = '1px solid #fde68a';\n      title.style.color = '#92400e';\n      title.innerHTML = 'Kryteria niespe\u0142nione';\n      if (rash) {\n        text.innerHTML = 'Przy obecnej typowej osutce sk\u00f3rnej nie osi\u0105gni\u0119to nawet poziomu possible DM.';\n      } else {\n        text.innerHTML = 'Przy braku osutki sk\u00f3rnej nie osi\u0105gni\u0119to nawet poziomu possible PM.';\n      }\n      note.innerHTML = 'Osutka typowa dla DM: ' + (rash ? 'tak' : 'nie') + '. Spe\u0142nione kryteria mi\u0119\u015bniowe: ' + muscleCount + '\/4' + (muscleList.length ? ' \u2014 ' + muscleList.join(', ') + '.' : '.');\n    }\n  });\n\n  clearBtn.addEventListener('click', function () {\n    document.getElementById('rx-bp-entry-no').checked = true;\n    document.getElementById('rx-bp-rash').checked = false;\n    document.getElementById('rx-bp-weakness').checked = false;\n    document.getElementById('rx-bp-enzymes').checked = false;\n    document.getElementById('rx-bp-emg').checked = false;\n    document.getElementById('rx-bp-biopsy').checked = false;\n\n    document.getElementById('rx-bp-result').style.display = 'block';\n    document.getElementById('rx-bp-result').style.background = '#f8fafc';\n    document.getElementById('rx-bp-result').style.border = '1px solid #e2e8f0';\n    document.getElementById('rx-bp-result-title').style.color = '#0f172a';\n    document.getElementById('rx-bp-result-title').innerHTML = 'Wynik pojawi si\u0119 tutaj';\n    document.getElementById('rx-bp-result-text').innerHTML = 'Zaznacz odpowiedzi, a nast\u0119pnie kliknij \u201eOblicz wynik\u201d.';\n    document.getElementById('rx-bp-result-note').innerHTML = 'Regu\u0142a: po wykluczeniu innych miopatii policz 4 kryteria mi\u0119\u015bniowe. Bez osutki klasyfikujesz PM; z typow\u0105 osutk\u0105 klasyfikujesz DM.';\n  });\n})();\n<\/script>","protected":false},"excerpt":{"rendered":"<p>Kalkulator klasyfikacyjny Zapalenie wielomi\u0119\u015bniowe (PM) oraz zapalenie sk\u00f3rno-mi\u0119\u015bniowe (DM) \u2014 Bohan i Peter Po wykluczeniu innych miopatii oceniane s\u0105 4 kryteria mi\u0119\u015bniowe. Typowa osutka sk\u00f3rna przesuwa klasyfikacj\u0119 w stron\u0119 dermatomyositis (DM); jej brak przemawia za polymyositis (PM). 1. Zastosowanie kryteri\u00f3w Najpierw oce\u0144, czy inne miopatie i rozpoznania alternatywne zosta\u0142y wystarczaj\u0105co wykluczone. Nieinne miopatie \/ lepsze&#8230;<\/p>","protected":false},"author":1,"featured_media":0,"parent":980,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_bbp_topic_count":0,"_bbp_reply_count":0,"_bbp_total_topic_count":0,"_bbp_total_reply_count":0,"_bbp_voice_count":0,"_bbp_anonymous_reply_count":0,"_bbp_topic_count_hidden":0,"_bbp_reply_count_hidden":0,"_bbp_forum_subforum_count":0,"_kadence_starter_templates_imported_post":false,"_kad_post_transparent":"","_kad_post_title":"","_kad_post_layout":"","_kad_post_sidebar_id":"","_kad_post_content_style":"","_kad_post_vertical_padding":"","_kad_post_feature":"","_kad_post_feature_position":"","_kad_post_header":false,"_kad_post_footer":false,"_kad_post_classname":"","footnotes":""},"class_list":["post-315","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/rheumanext.pl\/en\/wp-json\/wp\/v2\/pages\/315","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/rheumanext.pl\/en\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/rheumanext.pl\/en\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/rheumanext.pl\/en\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/rheumanext.pl\/en\/wp-json\/wp\/v2\/comments?post=315"}],"version-history":[{"count":5,"href":"https:\/\/rheumanext.pl\/en\/wp-json\/wp\/v2\/pages\/315\/revisions"}],"predecessor-version":[{"id":1146,"href":"https:\/\/rheumanext.pl\/en\/wp-json\/wp\/v2\/pages\/315\/revisions\/1146"}],"up":[{"embeddable":true,"href":"https:\/\/rheumanext.pl\/en\/wp-json\/wp\/v2\/pages\/980"}],"wp:attachment":[{"href":"https:\/\/rheumanext.pl\/en\/wp-json\/wp\/v2\/media?parent=315"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}