A 9 yr old girl has difficulty in combing hairs and climbing upstairs since 6 months. She has gower’s sign positive and maculopapular rash over metacarphalangeal joints. What should be the next appropriate investigation to be done ?

**Core Concept**
The clinical presentation suggests a diagnosis of **Juvenile Dermatomyositis (JDM)**, a rare autoimmune disorder characterized by muscle weakness and skin rash. The presence of **Gower's sign** indicates proximal muscle weakness, a hallmark of the disease.

**Why the Correct Answer is Right**
Although the correct answer is not provided, the investigation of choice for JDM typically involves assessing muscle damage and inflammation. This would likely include blood tests for **muscle enzymes** such as creatine kinase (CK) and aldolase, as well as **autoantibodies** associated with myositis.

**Why Each Wrong Option is Incorrect**
**Option A:** Without the specific option provided, it's challenging to determine its accuracy.
**Option B:** Similarly, without the option, its validity cannot be assessed.
**Option C:** And **Option D:** The same issue applies, as the options are not specified.

**Clinical Pearl / High-Yield Fact**
In cases of suspected JDM, it's crucial to perform a thorough **muscle biopsy** and assess for specific **autoantibodies** to confirm the diagnosis and guide treatment.

**Correct Answer:** Not provided in the query.

✓ Correct Answer: C. Creatine kinase