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Diagnostic Tests – Aldolase
1. What is it associated with?

Aldolase is an enzyme released from damaged skeletal muscle. It is elevated in inflammatory myopathies, particularly:


  • Polymyositis
  • Dermatomyositis
Other muscle enzymes are often elevated alongside aldolase, including creatine phosphokinase (CPK/CK) and sometimes creatinine.

2. When do you answer aldolase?

You should choose aldolase (or CPK) as the best initial diagnostic test when the clinical vignette suggests an inflammatory myopathy, such as:


  • An older woman with proximal muscle weakness
  • Difficulty rising from a chair or lifting arms
  • Associated myalgias
  • Characteristic skin findings, including:
    • Heliotrope rash
    • Gottron’s papules

Exam pearl:
Proximal muscle weakness + dermatomyositis rash → check aldolase or CPK first

3. What is the most accurate test?

While aldolase is useful for initial screening, the most accurate diagnostic tests for polymyositis and dermatomyositis are:
  • Electromyography (EMG)
  • Muscle biopsy
These tests confirm the diagnosis when muscle enzyme levels are elevated.


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Kembara Xtra 

Facts about medicine and its subtopic such as anatomy, physiology, biochemistry, pharmacology, medicine, pediatrics, psychiatry, obstetrics and gynecology and surgery.