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

A series of 38 "high risk" selected cases of deep venous thrombosis were studied in an internal Medicine Department. Fibrinogen-125I was used. Phlebographic verification was sought in those cases with a positive response to the fibrinogen. From the 38 cases 13 turned out to be positive; in 8 the venous thrombus was identify by venography. In two cases the dorsal venous arch could not be filled. In one case the phlebography could not be carried out. In the remaining two cases the venography did not show a thrombus but there was a pathologic fracture with hematoma and an ossifying myositis, respectively. Both cases were interpreted as false positives to the radioactive fibrinogen. One of them had suggestive clinical manifestations of deep venous thrombosis. Of the eight cases which were positive to the venography and radioactive fibrinogen only four showed a clinical picture suggestive of deep venous thrombosis. If the three cases with negative venographies are included only 36.3 percent of the patients had clinical manifestations. Among the 25 cases which were negative to the radioactive fibrinogen none of them had a clinical picture of deep venous thrombosis, although in 64 percent of them at least one of the clinical signs collected during the physical examination was positive. The correlation between fibrinogen-125I and phlebography turned out to be 80 percent.
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PMID:[The use of 125I-fibrinogen in the diagnosis of deep venous thrombosis in medical practice (author's transl)]. 52 63

After 2 weeks of ingestion of 130 g L-Tryptophan a 52 year old female develops an Eosinophilia Myalgia Syndrome with acute onset of deep venous thrombosis of forearm and possible initial cardiac manifestation featuring intermittent sinustachykardia. This is followed by a severe chronic disease (follow-up 15 months) with diffuse scleroderma and sensomotoric polyneuropathia. The deep muscle biopsy-specimen shows mononuclear infiltration of fascia and interstitial myositis with rare eosinophils. A blood eosinophilia (900/ul) occurs only in the initial acute onset of the illness. Plasma level of Kynurenine is significantly high (4000 pmol/ml), collagenneosynthesis is activated (Procollagen type III peptid 0.927 U/ml). No significant clinical improvement was seen with Acathioprine (100 mg/d) and Prednisolon (40-60 mg/d), after treatment with Ciclosporin scleroderma regresses completely, polyneuropathy is persisting.
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PMID:[L-tryptophan-associated chronic eosinophilia-myalgia syndrome treated with cyclosporin]. 141 38

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

The finding of muscle edema restricted to a single muscle compartment on MRI usually indicates a diagnosis of traumatic injury, myositis, denervation or neoplasm. This case demonstrates that deep venous thrombosis can also be the cause of isolated deep posterior compartment muscle edema in the calf and should be considered in the differential diagnosis even in the absence of diffuse soft tissue or subcutaneous edema.
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PMID:Unicompartmental muscle edema: an early sign of deep venous thrombosis. 1252 43

Myositis ossificans traumatica is a pathological condition characterized by extraskeletal bone formation, induced by major or repeated minor trauma to the muscles. Our objective is to report an unusual case of myositis ossificans traumatica in a paraplegic patient. Bilateral swelling and erythema on the thighs of a 1-month paraplegic inpatient was diagnosed as myositis ossificans traumatica in the quadriceps muscles due to low-molecular-weight heparin injections for deep vein thrombosis prophylaxis. As a result, repeated injections under the spinal cord injury level should be avoided when possible because of the risk of myositis ossificans traumatica.
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PMID:Subcutaneous injections as a risk factor of myositis ossificans traumatica in spinal cord injury. 1729 27

Deep venous thrombosis (DVT) is a major health problem and is estimated to have an incidence of 600,000 cases per year. Clinical signs and symptoms of DVT are unreliable. If clinical signs alone were used to diagnose DVT, 42% of patients would receive unnecessary anticoagulation therapy. Most patients evaluated with ultrasonography (US) do not have DVT. The key to making a precise diagnosis is recognizing the characteristics of various diseases on US images. The anatomic approach is the most useful strategy for characterizing the spectrum of pathologic conditions seen in patients with symptoms that simulate DVT. The inferior extremity can be divided into four regions-inguinal, thigh, popliteal, and lower leg-with the rough limits defined for each as they are examined at US. The differential diagnoses affecting the lower extremities include infectious, neoplastic, traumatic, inflammatory, vascular, and miscellaneous entities. Some pathologic conditions seen in the inguinal region are adenopathies, lymphangitis, soft-tissue tumors, hematomas, adductor tendonitis, and hernias. In the thigh, cellulitis, myositis, abscess, benign and malignant tumors, and sports-related lesions are seen. In the popliteal region, cellulitis, arthritis, benign and malignant masses, muscle contusions, ruptured popliteal cysts, and thrombophlebitis are seen. And in the lower leg, cellulitis, lipomas, tennis leg, superficial thrombophlebitis, tendonitis, and soft-tissue hydrostatic edema secondary to cardiac and renal failure can simulate DVT.
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PMID:Use of US in the evaluation of patients with symptoms of deep venous thrombosis of the lower extremities. 1893 36

Painful swelling of the calf is a common clinical problem. Distinguishing deep venous thrombosis from pseudothrombophlebitis can be difficult Pseudothrombophlebitis syndrome has been associated with ruptured/dissecting popliteal synovial cysts, localized myositis, inflammatory pseudotumor, popliteal artery aneurysm, and ruptured gastrocnemius, popliteal and/or plantaris tendon/muscles. In this report, we describe two patients for whom magnetic resonance imaging rapidly and accurately identified the cause of pseudothrombophlebitis, thus helping to avoid further testing and unnecessary anticoagulation.
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PMID:Calf pain and swelling (pseudothrombophlebitis) caused by rupture of the plantaris muscle/tendon. 1907 50

Three types of group A streptococcal infections are particularly feared: necrotizing fasciitis, myositis, and streptococcal toxic shock syndrome (TSS). We present 3 cases of necrotizing fasciitis due to Streptococcus pyogenes, one in an immunocompromised patient who had received kidney transplant and 2 healthy patients. Mean age of patients was 52 years (range, 42-67 years), and all 3 were male. One spontaneous case in absence of any obvious portal of entry is reported. The clinical course was initially indolent but quickly destructive. All patients required emergency surgical debridement and intravenous antibiotics. In 2 cases, intravenous immunoglobulin therapy was added. Differential diagnoses include septic arthritis, cellulitis, gout, other causes of tenosynovitis, erysipelas, and deep vein thrombosis.Blood and soft-tissue cultures should be obtained to identify the bacteria, and emergency computed tomography or magnetic resonance imaging scan should be performed to confirm the diagnosis and define the extension of the necrosis. Aggressive surgical debridement in the first 24 to 48 hours and antibiotic treatment, including penicillin and clindamycin, are the cornerstones in the management of these infections. Adjuvant intravenous immunoglobulin therapy might be useful in case of TSS. Diagnostic and treatment delays are the main causes of mortality in these infections.
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PMID:Necrotizing fasciitis and myositis caused by streptococcal flesh-eating bacteria. 2108 16

A 51-year-old female with a history of type 1 diabetes mellitus (DM) presented with sudden onset of pain and swelling of the left thigh. Her initial evaluation revealed mildly elevated erythrocyte sedimentation rate and creatine phosphokinase. Venous and arterial Doppler studies were negative for DVT and arterial thrombus. Further imaging with CT scan and then MRI revealed an irregular, enhancing space-occupying lesion of the left upper and mid-thigh. Subsequent muscle biopsy showed myonecrosis and proliferative myositis. Both findings are consistent with diabetic myonecrosis, which is a microvascular complication of long-standing poorly controlled DM. The patient was treated with analgesics, supportive care, and optimization of glycemic control. While short-term prognosis is good with adequate healing in a few weeks to several months, long-term prognosis is poor due to underlying extensive vascular disease. Although radiological findings are very suggestive of the diagnosis, most clinicians still need tissue biopsy to rule out other serious conditions such as infections and malignancy.
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PMID:Diabetic myonecrosis: a diagnostic challenge in patients with long-standing diabetes. 2388 92

Deep vein thrombosis (DVT) is a rare disease in pediatric patients. We report a pediatric patient who developed DVT in association with methicillin-resistant Staphylococcus aureus (MRSA) bacteremia complicated with septic arthritis, osteomyelitis, and myositis extensively. It is crucial to consider musculoskeletal infection associated with DVT in any child who presents with severe swollen limbs and limitations of motion. Prompt antibiotic and anticoagulant treatments should be initiated to reduce the risk of fatal complications.
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PMID:Musculoskeletal Sepsis Associated with Deep Vein Thrombosis in a Child. 2427 76


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