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Acute orbital myositis: case report
Bittar, Mirian S.;Garcia, Maria L.;Marchiori, Paulo E.;
Arquivos de Neuro-Psiquiatria , 1997, DOI: 10.1590/S0004-282X1997000100022
Abstract: the case of 22-year old, white woman with bilateral orbital myositis following an acute upper respiratory tract infection is reported. the most important clinical findings were ocular pain, proptosis, restricted eye motility and swelling of the eyelids. the enlarged eye muscles were seen on orbital computerized tomography scan. the clinical findings of inflammatory orbital myositis and clinical response to corticotherapy are emphasized.
Myositis Ossificans of the temporalis muscle: Case report
Manzano,Damián; Silván,ángel; Saez,Javier; Moreno,José Carlos;
Medicina Oral, Patología Oral y Cirugía Bucal (Internet) , 2007,
Abstract: the authors report an unusual case of myositis ossificans in the temporal muscle manifesting as grave opening limitation of the mouth and a hard firm mass in the right temporal fossa. ct scan examination revealed a bone density mass located in the region of the right temporal fossa, that fussed the right temporal bone with the right coronoid process and a joint-like image in the middle portion of this mass. traumatic myositis ossificans is a pseudotumor-like benign disease most frecuently found in extremities of young population. cases in the craneofacial skeleton are rare. the masseter and sternocleidomastoid muscles are most commonly affected in this location. the clinicopathological features of scalp myositis ossificans may mimic other soft tissue tumors, requiring care for the differential diagnosis. histologically, osteoblastic activity is sometimes observed, similar to an osteosarcoma. then differential diagnosis between both entities must be established.
Recurrent myositis triggered by infections: a case report
Sui H Wong, Bryan RF Lecky, Ian J Hart, Daniel Crooks, Tom Solomon
Journal of Medical Case Reports , 2008, DOI: 10.1186/1752-1947-2-344
Abstract: We report the case of a 24-year-old Caucasian woman with recurrent myositis triggered by sore throat, respiratory and urinary tract infections, over the past 18 years, up to four times a year. Myositis of this frequency and duration, apparently triggered by infections, has not been reported previously.We believe that this case adds to the understanding of myositis associated with infections being a triggered autoimmune response, and postulate that the pathogenesis in our patient is a non-specific immune response to a range of different precipitants, both bacterial and viral.Myositis can occur in association with infections. However, its pathogenesis is not clearly understood, and may be due to direct pathogenic invasion, for example, bacterial micro abscesses, or an autoimmune antigenic response. There may be serious consequences including rhabdomyolysis and acute renal failure. Recurrent myositis with different infections may suggest an autoimmune response from antigenic triggers. We describe such a case.A 24-year-old woman was referred in 2005 with increasing episodes of debilitating lower limb myalgia, since the age of seven. The attacks occurred every 1–2 years but had increased since 2005 to four per year. They were preceded by sore throats, and more recently, by cough or dysuria. During these episodes, creatine kinase (CK) ranged from 89 to 700 U/litre (normal range <175), normal between episodes. Her muscle pain responded to oral prednisolone within days.Because of the sore throats and an elevated antistreptolysin O titre (ASOT), she underwent a tonsillectomy in 1992. Apart from the tonsillectomy, her past medical history and drug history were unremarkable.We set out to fully investigate one of these attacks. In September 2005, an attack of muscle pains was preceded by cough and green sputum 2 weeks earlier. An examination was normal except for a slightly injected throat and tenderness of the calves and anterior compartment muscles. Biopsy of the right tibial
Brucellosis presenting as piriformis myositis: a case report
Pantelis Kraniotis, Markos Marangos, Alexandra Lekkou, Odysseas Romanos, Ekaterini Solomou
Journal of Medical Case Reports , 2011, DOI: 10.1186/1752-1947-5-125
Abstract: We report the case of a 19-year-old Caucasian man who presented to our institution with fever and right hip pain. Brucellosis was suspected, but the clinical suspicion was for spondylodiscitis. A pelvic magnetic resonance imaging scan allowed prompt diagnosis of inflammatory involvement of the right piriformis muscle. Blood culture results were positive for B. melitensis. Our patient was treated with antibiotics, and follow-up magnetic resonance imaging scans showed resolution of the inflammation.Brucellosis can present as piriformis myositis. The clinical diagnosis of piriformis myositis is difficult, as it can mimic other common entities such as referred back pain from spondylodiscitis. Magnetic resonance imaging is the method of choice for establishing the diagnosis in the early stages of the disease, as late diagnosis can lead to abscess formation and the need for drainage.Myositis is a rare muscle infection, with the most commonly implicated bacteria being Staphylococcus and Streptococcus. Piriformis myositis has been rarely reported in the literature [1-5]. Recognized predisposing factors for the condition are mainly previous viral or parasitic infections, rheumatic disease and HIV infection [6]. The clinical diagnosis of piriformis myositis is difficult, as it can present with hip pain and mimic sacroilitis or sciatica. Physical examination may be difficult as it is a deep infection and palpation may be inconclusive. We describe the case of a 19-year-old man who presented with fever and right hip pain due to piriformis muscle infection by Brucella melitensis.A 19-year-old Caucasian man presented to our emergency department complaining of right hip pain and fever. Our patient had been in excellent health until pain developed three days before his presentation. A day before admission, his temperature rose to 38.5°C, with rigors and sweating. He had no history of tobacco use, alcohol use, intravenous drug use, or any other factors for HIV infection. Our patient'
Case Report - Myositis Ossificans: Two Case Presentations
SG Lungu
Medical Journal of Zambia , 2011,
Abstract: Myositis Ossificans [MO], a florid ossification, may occur in muscles and soft tissue. It is also called by many different names. The lesion contains actively proliferating fibroblasts and osteoblasts and early in its development may be confused with a malignant tumor. It commonly affects vigorous young men and more so among athletes. Most often involved are the flexor muscles of the arm and the quadriceps femoris. By time of presentation, ossification is extensive and the benign nature of the lesion is usually evident on radiological studies. This paper presents two cases. While literature shows that MO is common in the flexor muscles of the arm, the hamstrings and quadriceps femoris, it is noted that other muscles of the thigh and around the hip joint can also be affected as demonstrated in the two cases presented here.
Myositis Ossificans Circumscripta of the Supra-orbital Region: A Case Report
SO Ajike, A Mohammed, ETO Adebayo, CN Ononiwu, OO Omisakin
Annals of African Medicine , 2007,
Abstract: Myositis ossificans circumscripta is a pathological condition characterized by formation of bony tissue within the skeletal muscles following repeated trauma. A case of myositis ossificans circumscripta of the supra-orbital region in a 25-year-old man is presented and the pertinent literature is reviewed. To the best our knowledge this benign lesion has not been reported previously in the orbital region the world literature. Clinically the patient presented with a swelling and proptosis of the right eye. Radiologically there was a rounded opacity with well defined margin. Lesion was initially misdiagnosed as a fibroosseous lesion; however microscopic examination indicated matured myositis ossificans. Lesion was excised via a bicoronal flap. Careful clinical, radiological and pathologic evaluation is required to make this uncommon diagnosis in an unusual location such as the supra-orbital region to avoid unnecessary surgical mutilation of the patient
Myositis ossificans circumscripta of the supra-orbital region: A case report
Ajike S,Mohammed A,Adebayo ETO,Ononiwu C
Annals of African Medicine , 2007,
Abstract: Myositis ossificans circumscripta is a pathological condition characterized by formation of bony tissue within the skeletal muscles following repeated trauma. A case of myositis ossificans circumscripta of the supra-orbital region in a 25-year-old man is presented and the pertinent literature is reviewed. To the best our knowledge this benign lesion has not been reported previously in the orbital region the world literature. Clinically the patient presented with a swelling and proptosis of the right eye. Radiologically there was a rounded opacity with well defined margin. Lesion was initially misdiagnosed as a fibro-osseous lesion; however microscopic examination indicated matured myositis ossificans. Lesion was excised via a bicoronal flap. Careful clinical, radiological and pathologic evaluation is required to make this uncommon diagnosis in an unusual location such as the supra-orbital region to avoid unnecessary surgical mutilation of the patient.
A Case Report on Parvovirus B19 Associated Myositis  [PDF]
Nathan D. Oliver,Auleen Millar,Adrian Pendleton
Case Reports in Rheumatology , 2012, DOI: 10.1155/2012/250537
Abstract: Introduction. Whilst there are reports of viral myopathies affecting children and the immunocompromised, infective myositis is a relatively rare inflammatory myopathy in adults. The clinical spectrum can range from benign myalgias to more serious complications in certain risk groups. Case Presentation. We present two cases of myositis as a result of parvovirus B19 infection. Conclusion. Viral myositis and parvovirus B19 associated myositis should be considered in adults presenting with significant myalgia. 1. Introduction Myositis is an inflammatory myopathy mainly associated with viral infection. The spectrum formed by the disease means presentation can range from vague muscular pain, swelling, and oedema to cardiac arrhythmias as a result of electrolyte disturbances from severe rhabdomyolysis. Of the suspected viral causes of myositis, parvovirus B19 is one of the least frequently recorded. This is thought to be a result of the acquired immunity developed by most adults over their lifetime. It follows that parvovirus B19 infects children more frequently; however, children rarely develop anything more than erythema infectiosum before recovery [1]. We describe two adult cases that developed myositis as a result of parvovirus B19 infection. 2. Case Presentation The first patient is a 42-year-old Caucasian male who presented with a four-week history of pain in his calves associated with inflammation, this soon progressed to involve his thighs and had an associated weakness. He further described ankle swelling, bilateral forearm pain, nocturnal hyperhidrosis, and recent contact with children diagnosed with “slapped cheek syndrome” associated with erythrovirus B19 infection. Physical examination revealed bilateral calf muscle hypertrophy, with pitting oedema of the ankles. Both lower limbs had decreased power (4/5) in all muscle groups. Initial blood tests revealed an elevated C-reactive protein and normal creatinine kinase. A muscle biopsy of the left thigh was performed yielding no pathological diagnosis, and a T2 and short TI inversion recovery MRI revealed bilateral marked intramuscular septal oedema of the soleus muscles and subcutaneous oedema of the lower legs. EMG showed mild myopathic changes but no spontaneous fibrillation. HIV/Hep B/C tests were negative; however, muscle biopsy was seen to be PCR positive for erythrovirus B19 with 32900?cop/m. The patient commenced prednisolone with significant clinical response within 2 weeks. The second patient is a 46-year-old Caucasian male with a background of antiphospholipid syndrome who presented with a
Iatrogenic tension pneumothorax in children: two case reports
Juan Mayordomo-Colunga, Corsino Rey, Alberto Medina, Andrés Concha
Journal of Medical Case Reports , 2009, DOI: 10.4076/1752-1947-3-7390
Abstract: Case 1: A 2-year-old boy with suspected brain death after suffering multiple trauma suddenly developed intense cyanosis, extreme bradycardia and generalized subcutaneous emphysema during apnea testing. He received advanced cardiopulmonary resuscitation and urgent bilateral needle thoracostomy. Case 2: A diagnostic-therapeutic flexible bronchoscopy was conducted on a 17-month-old girl, under sedation-analgesia with midazolam and ketamine. She very suddenly developed bradycardia, generalized cyanosis and cervical, thoracic and abdominal subcutaneous emphysema. Urgent needle decompression of both hemithoraces was performed.In techniques where gas is introduced into a child's airway, it is vital to ensure its way out to avoid iatrogenic tension pneumothorax. Moreover, the equipment to perform an urgent needle thoracostomy should be readily available.Pneumothorax can be classified as spontaneous, traumatic or iatrogenic [1]. The most frequent cause of iatrogenic pneumothorax is transthoracic pulmonary biopsy, but it also may appear as a complication of many other procedures [2]. Iatrogenic pneumothorax has been reported in up to 3% of adult patients admitted to intensive care units (ICU) [3]. Its management can be either conservative or aggressive depending on the patient's clinical status [4] and the size of the pneumothorax (a volume higher than 20% of pleural space indicates the need for pleural drainage [5]). For a tension pneumothorax (TPT), immediate air evacuation must be performed. Although most TPTs are traumatic, they can occasionally have an iatrogenic cause.A 2-year-old boy was admitted to our pediatric ICU after suffering severe multiple trauma. He progressed to refractory intracranial hypertension within 24 hours, and clinical tests indicated brain death. After preoxygenation with 100% FiO2 for 1 minute, apnea testing was performed using a supplemental oxygen cannula (an 8-French nasogastric tube) at a 6 L/minute flow rate through a 4.5 mm inner diameter (I
A case of parosteal osteosarcoma with a rare complication of myositis ossificans  [cached]
Spinelli Maria Silvia,Perisano Carlo,Rocca Carlo Della,Hardes Jendrick
World Journal of Surgical Oncology , 2012, DOI: 10.1186/1477-7819-10-260
Abstract: We report the case of a parosteal osteosarcoma of the distal ulna, treated with wide resection without reconstruction. The patient developed lung metastasis and a mass in the interosseus membrane of the forearm proximally to the osteotomy. The lung mass was found to be a metastasis from parosteal osteosarcoma and the biopsy of the forearm mass revealed a myositis ossificans. The suspicion of a recurrence of parosteal osteosarcoma, already metastatic, led to a second wide resection with no reconstruction. A slice of the radial cortex was taken during this second procedure. From a histological point of view, good margins were achieved and diagnosis of myositis ossificans was confirmed. Two months later, a radius fracture occurred and a synthesis, with plate and screws, as added with poly(methyl methacrylate) (PMMA) to reconstruct the bone loss, was performed. Indication of the reconstructive technique and the complication after distal ulna resection in oncologic surgery are discussed in this paper.
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