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PubMed1998

[Myositis ossificans circumscripta and sequelae of muscular ischemia. 2 cases].

INTRODUCTION: Non-traumatic myositis ossificans circumscripta is a relatively rare, well defined entity. The pathogenic role of ischemia in its development is discussed. EXEGESIS: We report two cases of myositis ossificans circumscripta that occurred in the hamstring muscle respectively 22 and 35 years after ischemic muscular injury in the same site. Clinical and radiologic informations and follow-up were reexamined, showing that patients are usually young and that the disease is equally distributed between both genders. Though the lesion may develop in various muscle, it is preferentially observed in proximal sites. Most patients have a history of localized pain or tenderness accompanied by swelling of the affected site. Following a 5- to 12-week increase, the soft-tissue mass is less sensitive and better defined. It may also resolve in less than 3 years. CONCLUSION: Results of X rays, computerized tomography, MR imaging and biopsy are reviewed. Histologically, this lesion main feature is peripheral bone maturation within three areas. Mechanisms (traumatic or not) underlying these lesions are unknown. To our knowledge, only one published case would be comparable to ours. Proliferation followed by change in mesenchymal cells leading to heterotopic ossification must be regarded as a consequence of either ischemia or repeated micro-trauma occurring during muscle shortening.

Follow-Up Studies↗
PubMed1986

Traumatic myositis ossificans in masticatory muscles.

3 cases of traumatic myositis ossificans circumscripta, located within the masticatory muscles are presented. Two of the lesions involved the masseter muscle, and exceptionally, 1 involved the temporalis muscle. Three pathognomonic histological zones, permitting the differential diagnosis of myositis ossificans from sarcomatous lesions, are described, and treatment incorporating ideally early surgical intervention with wide excisional biopsy of the lesion is stressed.

Adolescent↗
PubMed2004

[Mycobacterium chelonae myositis].

INTRODUCTION: Mycobacteria are only exceptionally responsible for infection of the skin and soft tissues. A Mycobacterium chelonae myositis occurred in an immunodepressed patient. OBSERVATION: A 49 year-old man, treated for many years with corticosteroids for vasculitis of the lower limbs associated with rheumatoid polyarthritis, was hospitalized for invasive pulmonary aspergillosis. Ten days later he developed myositis of the right arm with multiple subcutaneous abscesses. Culture of the purulent substance isolated Mycobacterium chelonae. Treatment with ciprofloxacine and clarithromycine led to the regression of the lesions. He was followed-up for 12 months. DISCUSSION: M. chelonae is found in large quantities in the environment. Infection with this mycobacteria is enhanced by immunodepression, notably that secondary to corticosteroid therapy. Resistance to antibiotics are frequent. Clarithromycine is highly effective against this mycobacteria. Bi-therapy is recommended to avoid the emergence of resistance.

Adrenal Cortex Hormones↗
PubMed1997

Tenascin-C expression correlates with macrophage invasion in Duchenne muscular dystrophy and in myositis.

Tenascin-C (TN-C) is an extracellular matrix protein expressed during development in several tissues, but restricted to only a few areas in normal adult tissues. By immunizing mice with human fetal myoblasts we generated a monoclonal antibody to TN-C and mapped the epitope to the aminoterminal end containing EGF-like repeats. Using this antibody we detected by immunohistochemistry TN-C in the epimysium and perimysium of human fetal muscles, as well as in nonfibrillar deposits in myoblast cultures. In situ hybridization did not reveal any signal within human fetal muscle groups, suggesting that non-muscle cells synthesize the majority of the tenascin that localizes in and around human fetal muscle. Immunohistochemical analysis of muscle biopsies from Duchenne/Becker muscular dystrophy and myositis patients revealed that TN-C is expressed in skeletal muscle. Although the patterns of TN-C immunoreactivity were quite different in the two disease entities, the endomysial TN-C reactivity in both DMD/BMD and in myositis invariably correlated with the presence of macrophages.

Antibodies, Monoclonal↗
PubMedDate not supplied

Myositis ossificans of the foot.

A 37-year-old woman with myositis ossificans of the left foot is reported. A faint density was seen on foot radiographs, whereas computed tomography images showed a rim of mineralization inferior to the second and third metatarsal bones. On short tau inversion recovery-weighted magnetic resonance images, a hyperintense lesion was demonstrated with hyperintensity extending to the surrounding soft tissues. The rim of ossification appeared hypointense. Other non-neoplastic soft tissue processes with bone formation such as pseudomalignant osseous tumor of soft tissues, florid reactive periostitis, and bizarre parosteal osteochondromatous proliferation occur more commonly in the foot than myositis ossificans. A differential diagnosis of these lesions including periosteal and parosteal osteosarcoma, periosteal chondroma, and osteomyelitis is discussed.

Adult↗
PubMed1996

Focal myositis of the floor of mouth: report of two cases and review of the literature.

Focal myositis is an uncommon inflammatory myopathy of unknown cause affecting skeletal muscle. It may be mistaken on clinical evaluation for a malignant neoplasm. We describe two cases, both involving the mylohyoid muscle of the floor of the mouth. In each case excisional biopsy of a firm indurated mass revealed a focal lymphocytic and histiocytic infiltrate associated with degenerating and regenerating skeletal muscle fibers. No clinical or biochemical evidence of generalized muscle disease was seen at presentation or at 1-year and 7-year follow-up examination. The literature on focal myositis involving the head and neck region is reviewed.

Adult↗
PubMed1997

Myositis ossificans traumatica of the masseter muscle: review of the literature and report of two additional cases.

Myositis ossificans traumatica of the masseter muscle is uncommon. The condition is benign and results in reactive heterotopic bone formation, usually producing limitation of opening of the jaws. Radiographic and microscopic examination can confirm the diagnosis. Treatment of myositis ossificans traumatica of the masseter muscle is surgical, with other modalities used when occurring in other muscles of the body.

Adolescent↗
PubMed1998

Focal myositis of the sternocleidomastoid muscle.

Focal myositis is an unusual inflammatory lesion of skeletal muscle. It usually affects the extremities, but can present rarely in the head and neck region. We present a case of an elderly woman with focal myositis of the sternocleidomastoid muscle and review of the previous literature on this subject.

Aged↗
PubMed2001

Myositis, microvesicular hepatitis, and progression to cirrhosis from troglitazone added to simvastatin.

A 68-year-old woman, with type 2 diabetes mellitus, hypercholesterolemia, and prior long-term simvastatin therapy, self-resumed troglitazone after running out of metformin. She developed an acute severe hepatitis with microvesicular steatosis and mysositis. There was subsequent resolution of the myositis but progression of the hepatitis to symptomatic cirrhosis over a period of 12 weeks. Both troglitazone and simvastatin are metabolized by cytochrome P-450 3A4. Troglitazone typically induces metabolism of drugs metabolized by this cytochrome so that simple simvastatin toxicity seems less likely to have been involved. The association with myositis, the severity of the hepatitis with progression to cirrhosis, and the presence of microvesicular steatosis suggests altered mitochondrial metabolism, which has been described with each agent, as the underlying pathogenic mechanism. Although troglitazone (Rezulin) has been withdrawn from the market, other similar agents are available for therapy of type 2 diabetes mellitus. Increased awareness of a potential interaction between these two classes of drugs is warranted.

Aged↗
PubMed2001

Intravenous immunoglobulin prevents experimental autoimmune myositis in SJL mice by reducing anti-myosin antibody and by blocking complement deposition.

High-dose intravenous immunoglobulin (IVIG) therapy has been effective in many autoimmune and systemic inflammatory diseases including polymyositis (PM) and dermatomyositis (DM). In the present study we evaluated the efficacy of IVIG using experimental models of PM and DM. An experimental autoimmune myositis (EAM) model was produced in SJL/J mice by an immunization with rabbit myosin B (MB) fraction. In this model, the plasma level of anti-MB antibody was elevated, and mouse IgG and complement C3 were deposited in the muscle fibres. Administration of IVIG dose-dependently reduced the incidences of necrotic and inflammatory changes in the skeletal muscle. IVIG treatment also decreased the elevation of anti-MB antibody level, as well as the deposition of IgG and C3. We next evaluated the effect of IVIG in adoptive EAM mice made by an intravenous injection of lymph node cells previously stimulated with MB. Adoptive EAM mice showed similar lesions in skeletal muscle as EAM mice and IVIG inhibited the lesion development. In vitro experiments demonstrated that IVIG inhibited complement-mediated lysis of human erythrocytes sensitized with anti-human erythrocyte antibodies. The binding of C1q, C4 and C3 to the same cells was also inhibited by IVIG. Taken together these findings suggest that IVIG prevents the development of myositis in EAM and adoptive EAM models by several mechanisms, such as reducing anti-myosin antibody and by blocking complement activation. Our present findings might account for the clinical efficacy of IVIG in PM and DM patients.

Adoptive Transfer↗
PubMed1997

Myositis ossificans-like lesion of nerve.

An unusual ossifying lesion arising within the median nerve of a young adult male is presented. While ectopic ossification has been described in a large number of sites, intraneural ossification is an uncommon event and usually occurs in association with a pre-existing intraneural neoplasm. This case, in contrast, bears striking histopathological resemblance to myositis ossificans with prominent zonation. We believe that this may represent the first example of a benign myositis ossificans-like lesion of nerve.

Adult↗
PubMed1999

Group A streptococcal myositis.

Myositis is a relatively uncommon presentation of group A streptococcal infection. We present a case of a 3-year-old girl with group A streptococcal myositis primarily involving the soleus muscle. Magnetic resonance imaging was valuable in localizing the affected muscle and avoiding surgical exploration.

Child, Preschool↗
PubMed1999

Dalmeny disease in an alpaca (Lama pacos): sarcocystosis, eosinophilic myositis and abortion.

Disseminated eosinophilic myositis was diagnosed in an alpaca that had been imported to the USA from Peru 5 years earlier. The myositis was associated with macroscopically visible large sarcocysts that were characterized histologically by septate compartments containing bradyzoites, and ultrastructurally by cyst walls composed of anastomosing villous protrusions. Two hours before death, the alpaca aborted an 8-month-gestation fetus, but no lesions were found in the uterus, placenta or fetus. Additional macroscopical findings included haemoabdomen and myofibre haemorrhage, degeneration and necrosis. It is believed that this is the first described case of clinical disease associated with a Sarcocystis sp. (probably S. aucheniae) in camelids.

Abortion, Veterinary↗
PubMed2002

Streptococcal myositis: a lesson.

Streptococcal myositis is a rare, often fatal, acute infection of the muscle, caused by an invasive group A beta-haemolytic streptococcus. It is characterised by muscle necrosis without abscess formation, and, in contrast to necrotising fasciitis, does not primarily affect the subcutaneous tissue or skin. A young adult male presented with streptococcal myositis initially affecting the rectus femoris muscle of his left thigh. The symptoms, signs and management are discussed. Particular emphasis is given to the benefits of emergency CT scans to diagnose and delineate the extent of the disease. These scans may need to be repeated if the disease progresses. The four cornerstones of management are: early diagnosis using emergency CT scans; high-dose intravenous antibiotics; early aggressive surgical debridement; and intensive fluid and nutritional support. Published by Elsevier Science Ltd. All rights reserved.

Adult↗
PubMed2002

Traumatic myositis ossificans (ossifying pseudotumor) of temporal muscle.

The purpose of this paper is to present the clinical, radiographic, and histological aspects of a case of traumatic myositis ossificans of the temporal muscle. This is a rare, benign ossifying pseudotumor of skeletal muscles. It had developed 3 weeks after trauma to the left temple in a 33-year-old man. Differential diagnostic aspects of traumatic myositis ossificans confirming its benign character are discussed.

Adult↗
PubMedDate not supplied

[Myositis caused by a mycoplasma infection].

UNLABELLED: Mycoplasma pneumonia infection can be associated with neurological manifestations such as meningoencephalitis, cerebellitis, aseptic meningoitis, polyradiculopathy, transverse myelitis, cranial nerve palsies and myositis [4, 5]. We report a case of a white female 11 years, 2 months old child, who presented with a 3 day history of pain in the left leg. The electromyograpy showed pathological signs. We found a serological titer of IgM antibodies for Mycoplasma pneumoniae. By treatment with erythromycin the complaints improved quickly. CONCLUSION: A myositis can be caused with an infection with Mycoplasma pneumoniae. The differential diagnosis is essential.

Antibodies, Bacterial↗
PubMed2002

[Diagnosis and treatment of streptococcal myositis].

HISTORY AND CLINICAL FINDINGS: Case 1: Following an influenza a 40-year-old patient was treated by intramuscular injections for backache. 24 hours later he was admitted to a hospital with massive pain in both lower extremities and a markedly reduced general condition. Case 2: Two days after a knee joint arthroscopy a 57-year-old man developed strong pain in the extremity treated by application of diclofenac. On the following day the patient was admitted to a university hospital in a septic state with a swollen, cold and blurry changed extremity. INVESTIGATIONS: The myoglobin concentration was dramatically increased in both cases (> 15 000 mg/l). CRP values were elevated. The progressive septic state with acute renal failure was verified by elevation of creatinine concentration and decrease of leukocyte values in the second case (from 10/nl to 2,5/nl) shortly after admission. DIAGNOSIS, TREATMENT AND COURSE: Both the patients died for septic shock. Case 1 died shortly after admission before surgical intervention. The second patient developed rapid progression of the myositis including the trunk despite radical surgical treatment (hip joint exarticulation). CONCLUSION: In cases of sudden and painful swelling of an extremity of unknown origin or following intramuscular injection streptococcal myositis has to be taken into account. Only an immediate surgical intervention up to amputation of the affected extremity can stop the fatal course.

Acute Kidney Injury↗