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Query: UMLS:C0027121 (myositis)
 4,538 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Exertion-related muscle pain is frequent in athletes and patients alike; however, its severity and significance may be difficult to assess clinically. MRI can be used to evaluate myalgia, strains, delayed-onset muscle soreness, chronic muscle overuse syndromes, muscle contracture, and sequellae of muscle injuries such as myositis ossificans and compartment syndrome. MRI documents the distribution of affected muscles, the presence of focal hematoma, fascial herniation, and subsequent healing, fibrosis, or fatty infiltration. MRI is useful in evaluating acute and delayed exertional muscle injuries.
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PMID:Exertional muscle injuries: magnetic resonance imaging evaluation. 191 Aug 28

Acute compartment syndrome of the thigh has been reported infrequently. To date, only eight cases from isolated blunt trauma without fracture have been reported. Two additional cases caused by intramuscular hematomas following blunt, low-energy trauma, which were treated successfully with emergency fasciotomies, are presented. The morbidity from this syndrome varies from mild, with quadriceps weakness, fatigue, and myositis ossificans, to severe, with limb-threatening vascular compromise. Morbidity can be avoided if a high level of suspicion is maintained, compartment pressures are measured, fasciotomies are performed, and hematomas are drained. Postoperatively, patients can expect a dramatic decrease in pain and a quick return of quadriceps function with aggressive physical rehabilitation.
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PMID:Acute anterior thigh compartment syndrome complicating quadriceps hematoma. Two case reports and review of the literature. 218 98

A 49-year-old woman with chronic renal failure was given gemfibrozil for hyperlipidemia. She developed gemfibrozil-induced myositis which precipitated an acute compartment syndrome, necessitating emergency fasciotomy. The muscle biopsy showed prominent degeneration of the skeletal muscle fibers, associated with moderate chronic inflammatory infiltration. Electron microscopy revealed myofibrillary fragmentation and mitochondrial disorganization. The clinicopathologic features of gemfibrozil-induced myositis appear to be distinct from those of clofibrate-induced muscular syndrome. Extreme caution should be exercised in the use of gemfibrozil in patients with impaired renal function.
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PMID:Gemfibrozil induced myositis: a case report with light microscopic and ultrastructural study. 800 60

Three new cases of toxic shock syndrome due to infection with group A beta-hemolytic streptococci are described and similar cases in the literature are reviewed. The typical features of this disease include rapid development of multiorgan failure with renal impairment and, in many patients, also the respiratory distress syndrome. Cardiac dysfunction with myocardial depression is a prominent feature which is most reasonably explained by an effect of the septicaemia per se but may also be toxic cardiomyopathy mediated by circulating toxins. Other major findings include exanthema--often with the development of haemorrhagic bullae as part of toxic epidermal necrolysis. In patients with initial soft tissue infection this is rapidly progressive and often associated with necrotizing fasciitis and myositis, which may give rise to a compartment syndrome with rhabdomyolysis. In addition to conventional therapy with antibiotics, fluid replacement and inotropics, most patients with extensive soft tissue infection also require surgical intervention with debridement and occasionally fasciotomy.
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PMID:[Toxic shock syndrome in group A streptococcal infection]. 842 63

In the field of traumatology, compartment syndromes of the lower extremity are often seen after fractures and direct injuries, or after ischaemia. Other causes include over-exertion and non-traumatic causes such as acute rhabdomyolysis, drug-induced myositis and eosinophilic myositis. This paper describes the clinical and MR course of a compartment syndrome following an ankle sprain.
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PMID:[Acute compartment syndrome of the lower leg after ankle joint sprain. A case report]. 957 21

Exertional compartment syndrome is characterized by intracompartmental pressures that rise transiently following repetitive motion or exercise, thereby producing temporary, reversible ischemia, pain, weakness, and, occasionally, neurologic deficits. The exact cause or pathogenesis remains unclear; a disturbance of microvascular flow caused by elevated intramuscular pressure leads to tissue ischemia, depletion of high-energy phosphate stores, and cellular acidosis. Anatomic contributing factors may include a limited compartment size, increased intracompartmental volume, constricted fascia, loss of compartment elasticity, poor venous return, or increased muscle bulk. The diagnosis is suspected based on history and confirmed with physical examination and intramuscular pressure evaluation before and after exercise (stress test). Differential diagnosis includes claudication or other vascular abnormalities, myositis, tendinitis, periostitis, chronic strains or sprains, stress fracture, other compression or systemic neuropathies, and cardiac abnormalities with angina or referred extremity pain. Initial treatment includes activity modification; refractory symptoms can be managed with elective fasciotomy.
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PMID:Exertional compartment syndrome of the upper extremity. 974 26

A 44-year-old woman with a 5-year history of poorly controlled Type 1 diabetes mellitus presented with a painful, firm and warm swelling in her right thigh. Pain was severe but the patient was not febrile, and had no history of trauma or abnormal exercise. Laboratory tests showed ketoacidosis, major inflammation (erythrocyte sedimentation rate (ESR) = 83 mm/h), normal white blood cell count and normal creatine kinase level. Plain radiographs were normal, and there were no signs of thrombophlebitis at Doppler ultrasound. Magnetic resonance imaging (MRI) showed diffuse enlargement and an oedematous pattern of the adductors, vastus medialis, vastus intermedius and sartorius of the right thigh. The patient's symptoms improved dramatically, making biopsy unnecessary, and a diagnosis of diabetic muscular infarction was reached. Idiopathic muscular infarction is a rare and specific complication of diabetes mellitus, typically presenting as a severely painful mass in a lower limb, with high ESR. The diabetes involved is generally poorly controlled longstanding Type 1 diabetes with established microangiopathy. Differential diagnoses include deep vein thrombosis, acute exertional compartment syndrome, muscle rupture, soft tissue abscess, haematoma, sarcoma, inflammatory or calcifying myositis and pyomyositis. In fact, physician awareness should allow early diagnosis on the basis of clinical presentation, routine laboratory tests and MRI, thereby avoiding biopsy and its potential complications as well as unnecessary investigations. Rest, symptomatic pain relief and adequate control of diabetes usually ensure progressive total recovery within a few weeks. Recurrences may occur in the same or contralateral limb.
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PMID:Painful swelling of the thigh in a diabetic patient: diabetic muscle infarction. 1049 95

This is a case of influenza A induced rhabdomyolysis resulting in extensive compartment syndrome and acute renal failure in a 10-year-old child. The patient required fasciotomies in all four extremities. Even after fasciotomies were performed, the muscle tissue continued to swell, suggesting a primary myositis. This case emphasizes the importance of considering the diagnosis of compartment syndrome in patients with influenza infection and severe myalgia.
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PMID:Influenza A induced rhabdomyolysis resulting in extensive compartment syndrome. 1085 75

Abnormal signal intensity within skeletal muscle is frequently encountered at magnetic resonance (MR) imaging. Potential causes are diverse, including traumatic, infectious, autoimmune, inflammatory, neoplastic, neurologic, and iatrogenic conditions. Alterations in muscle signal intensity seen in pathologic conditions usually fall into one of three recognizable patterns: muscle edema, fatty infiltration, and mass lesion. Muscle edema may be seen in polymyositis and dermatomyositis, mild injuries, infectious myositis, radiation therapy, subacute denervation, compartment syndrome, early myositis ossificans, rhabdomyolysis, and sickle cell crisis. Fatty infiltration may be seen in chronic denervation, in chronic disuse, as a late finding after a severe muscle injury or chronic tendon tear, and in corticosteroid use. The mass lesion pattern may be seen in neoplasms, intramuscular abscess, myonecrosis, traumatic injury, myositis ossificans, muscular sarcoidosis, and parasitic infection. Some of these conditions require prompt medical or surgical management, whereas others do not benefit from medical intervention. The ability to accurately diagnose these conditions is therefore necessary, and biopsy may be required to establish the correct diagnosis. Clues to the correct diagnosis and whether biopsy is necessary or appropriate are often present on the MR images, especially when they are correlated with clinical features and the findings from other imaging modalities.
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PMID:Abnormal signal intensity in skeletal muscle at MR imaging: patterns, pearls, and pitfalls. 1104 80

Muscle derangements in athletes have a wide variety of causes, treatments, and prognoses. Given that the cause and severity of sports-related injuries may be difficult to determine clinically in some cases, MR imaging is utilized increasingly to evaluate muscle injuries in athletes. After reviewing useful MR imaging techniques, this article focuses on MR imaging of the most common causes of muscle pain and disability in athletes, including myotendinous strain, delayed onset muscle soreness, muscle contusion, myositis ossificans, muscle laceration, muscle herniation, and compartment syndrome. The differential diagnosis of various signal intensity abnormalities in muscle also is reviewed.
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PMID:Imaging of sports-related muscle injuries. 1211 28


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