Unilateral Lower Limb Focal Myositis

  • Dr. Sandesh Ghiya, Dr. Rajbhoj A, Dr. Bhosale D, Dr. Patil A, Dr. Sugnan A, Dr. Diwan A, Dr. Dave P, Dr. Lumb R.
Keywords: Myositis, Focal, MRI, Electromyography, Inflammatory myopathy

Abstract

Focal myositis is a rare inflammatory myopathy characterised by a localised swelling of skeletal muscle that is usually located in the lower extremities. It can be readily confused with tumours or other inflammatory diseases and around one hundred cases are described in the global literature. Focal myositis presents as a mass localised to a single skeletal muscle that may be painless or tender to the touch and that appears after growing insidiously over several weeks to months. The mass is usually located in the lower extremities and the muscles most commonly affected include the adductor, vastus lateralis and gastrocnemius. It can rarely occur in muscles of the head and neck region. We report a case of a 60 year old, female patient who developed swelling in calf muscle without the history of trauma. She came with a pai nful swelling appearing on the right lower limb, growing progressively in the last 10 days, followed by a spontaneous moderate local pain, getting worse on movement. MRI showed a diffuse high signal intensity in the right gastrocnemius muscle, images revealed oedematous changes in adjacent soft tissues and signs corresponding to myositis. The collective findings were consistent with a diagnosis of focal myositis. Appropriately, non-steroidal anti-inflammatory therapy with physical therapy was performed. A physical examination performed 14 days after initiation of the treatment, revealed improvement in tenderness and pain.

References

1. Yanmaz Alnigenis MN, Kolasinski SL, Kalovidouris AE. Focal myositis: a review of 100 previously published cases and a report of 2 new cases. Clin Exp Rheumatol.
1999;17(5):631.
2. Mielnik P, Chwalińska-Sadowska H, Wagner T. Focal myositis. Case Rep Clin Pract Rev. 2003;4(3):157-159.
3. Manickavasagam J, Majumdar S, Bhattacharyya AK. Focal inflammatory myositis of the paraspinal neck muscles. Ear Nose Throat J. 2008;87:430-432.
4. Llauger J, Bagué S, Palmer J, Matías-Guiu X, San Román L, Doncel A. Focal myositis of the thigh: unusual MR pattern. Skeletal Radiol. 2002;31:307-310.
5. Heffner RR, Armbrustmacher VW, Earle KM. Focal myositis. Cancer.1977; 40:301–6.
6. Cumming W, Weiser R, Teoh R, Hudgson P, Walton J. Localized nodular myositis: a clinical and pathological variant of polymyositis. Q J Med. 1977;46:531-46.
7. Flaisler F, Blin D, Asencio G, Lopez FM, Combe B. Focal myositis: a localized form of polymyositis? J Rheumatol. 1993;20:1414–6.
8. Auerbach A, Fanburg-Smith JC, Wang G, Rushing EJ. Focal myositis: a clinicopathologic study of 115 cases of an intramuscular mass-like reactive process. Am J SurgPathol.
2009;33:1016-1024.
9. Gaeta M, Mazziotti S, Minutoli F, Genitori A, Toscano A, Rodolico C, Blandino A. MR imaging findings of focal myositis: a pseudotumour that may mimic muscle neoplasm.
Skeletal Radiol. 2009; 38: 571-578.
Published
2019-08-08
How to Cite
Dr. Sandesh Ghiya, Dr. Rajbhoj A, Dr. Bhosale D, Dr. Patil A, Dr. Sugnan A, Dr. Diwan A, Dr. Dave P, Dr. Lumb R. (2019). Unilateral Lower Limb Focal Myositis. The Indian Practitioner, 68(10), 33-35. Retrieved from https://articles.theindianpractitioner.com/index.php/tip/article/view/546