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PubMed1975

Experimental myositis in rats. II. The sensitivity of spleen cells to syngeneic muscle antigen.

The transformation responses to a syngeneic muscle homogenate of spleen cells, lymph node cells and blood lymphocytes have been studied in rats with allergic myositis. Significantly increased responses to muscle were obtained only for spleen cells from rats which had received two or more immunizing injections of heterologous muscle with Freund's complete adjuvant. Other populations of lymphoid cells which had previously been shown to be capable of transferring the disease did not show significant transformation responses to muscle. Increased responses in spleen cells were obtained using a supernatant ultracentrifugal fraction as well as a whole muscle homogenate. Fractionation of the antigen showed blast stimulating activity to be present in fractions of differing molecular size, suggesting that the antigen(s) responsible may be present in polymeric form or may be bound to molecules of varying molecular size.

Animals↗
PubMed2002

Magnetic resonance imaging criteria for distinguishing between inclusion body myositis and polymyositis.

OBJECTIVE: To develop diagnostic imaging criteria for polymyositis (PM) and sporadic inclusion body myositis (sIBM). METHODS: We investigated 220 patients with suspected inflammatory myopathies by magnetic resonance imaging (MRI). Findings were compared with the results of clinical and biological examinations and muscle biopsy. PM and IBM were diagnosed in 25 patients each. Quantitative and qualitative MRI analysis of the 3 muscle groups of the 2 thighs included fatty infiltration, atrophy, inflammation, and the type and distribution of the lesions. RESULTS: MRI was abnormal in all patients. Fatty infiltration and atrophy were more frequent in patients with sIBM (p < 0.05). Inflammation as the sole abnormality was preferentially encountered in PM (p = 0.05). Widespread abnormalities were more frequent in sIBM (p < 0.01). Abnormalities in PM tended to be distributed along the fascia. Involvement of the anterior group, an asymmetrical distribution, and a distal predominance were all more frequent in sIBM (p < 0.001). CONCLUSION: Despite some overlap in MRI findings between the 2 diseases, MRI was useful for distinguishing PM from sIBM.

Adult↗
PubMed2002

Clinical observations of pharmaceutical, physical, and visual evidence of presumed extraocular myositis and tendonitis.

PURPOSE: This study examines data from pharmaceutical, physical, and visual tests that support the possible diagnosis of presumed extraocular myositis and tendonitis (PEM-T). METHOD: The presence of ocular pain derived from inflamed extraocular musculature and tendons in 60 subjects with PEM-T was detected by palpating their globes near the eye muscle insertions. The pain sensations were subjectively rated and recorded. Because the sensation of pain elicited by such palpation was most-often unilateral, the study compares the affected sidewith pain to the side tha exhibited vision disturbance during the Turville Infinity Binocular Balance (TIB) test. Lastly, an anti-inflammatory ophthalmic pharmaceutical was used to see if the pain could be resolved. Saline was used as a control. The subjects evaluated their pain after 1 and 10 minutes of the saline drop. The remaining subjects who still had pain after the saline drops were given one of two topical steroids: a hydrophilic or a lipaphilic derivative of prednisolone. Again, the subjects rated and recorded their pain after 1, 10, and 60 minutes. RESULTS: Of 60 subjects who had headaches and associated painful areas on their globes, 5B observed the monocular blur effect (MBE) on the same side as these palpable sore spots. Of the 60 subjects with such sore areas, 10 individuals were relieved with a saline drop. Of the remaining 50 subjects, 25 received a drop of lipophilic, prednisolone acetate and 25 received a drop of hydrophilic, prednisolone sodium phosphate. Of the 50 subjects from these two groups, 39 had a significant reduction of their palpable pain sensations; the data indicate there was little difference in response between the two formulations of prednisolone. CONCLUSION: The corroboration of results from pharmaceutical, physical, and visual tests supports the diagnosis of PEM-T.

Adult↗
PubMed2002

Understanding the immunopathogenesis of inclusion-body myositis: present and future prospects.

Sporadic Inclusion Body Myositis (s-IBM) is the most common acquired inflammatory myopathy. It has a stereotypic clinical presentation and a predictably progressive course that leads to severe muscle weakness and permanent disability. The combination of primary endomysial inflammation with autoimmune features identical to those seen in Polymyositis, and degenerative features with vacuolization of muscle fibers and deposits of tiny speckles of amyloid, are characteristic for the disease. In this review, the immunopathology of IBM is detailed. The inflammation which is prominent even late in the disease, is characterized by activated, CD8+ cytotoxic T cells that secrete perforin and invade MHC-I-expressing muscle fibers. The autoinvasive T cells are probably antigen driven because of specific rearrangement of their T Cell Receptor profile, restriction of the CDR3 region, upregulation of co-stimulatory molecules and their ligands on the muscle fibers, and activation of various cytokines, chemokines and adhesion molecules. The disease can be seen in association with HIV and HTLV-I infection, but viruses have not been amplified from the muscle fibers and the antigen or the factors that trigger inflammation are still unknown. The disease is mysteriously resistant to conventional immunotherapies in spite of the immunopathologic similarities with PM. The cause of the vacuolar formation in IBM is also unknown and the role, that the tiny amyloid deposits play in the disease remain unclear. The treatment approaches and the prospects for future immunotherapeutic interventions are discussed.

Electromyography↗
PubMed2002

[Necrotising fasciitis and myositis as serious complications after liposuction].

Three days after liposuction of the lower abdomen, a 41-year-old woman was admitted for toxic shock-like syndrome with necrotising fasciitis and myositis, caused by Lancefield-group-A beta-haemolytic streptococci. The patient was treated by radical debridement of the skin, subcutis, fasciae and part of the pectoral muscle, plus antibiotics. Postoperatively she required artificial respiration for respiratory insufficiency. One week after the operation the wound was covered by transplantation of autologous skin. The patient survived, but was seriously disfigured. Necrotising fasciitis is a progressive soft-tissue infection, characterised by widespread necrosis of the superficial and deep fascia, often associated with severe systemic toxic reactions. Unless quickly recognised and aggressively treated, the course is often fatal. Due to the absence of cutaneous findings in the early stages, diagnosis is difficult. Important diagnostic aids are routine laboratory tests, contrast-MRI and a combination of the finger test and frozen-section biopsy. Treatment consists of early radical debridement, broad-spectrum antibiotics and supportive care. In a later stage, soft-tissue reconstruction with autografts or artificial skin grafts and skin transposition can be performed.

Adult↗
PubMed2002

Statin-induced myositis migrans.

Muscle related side effects of statins might be more frequent than once considered. Without affecting CK, they appear in various forms. Here, for the first time, we describe a new appearance we call "Statin-induced myositis migrans" in a 74-year-old female. Symptoms appeared more during the day and were not related to exercise. They were seen after simvastatin, pravastatin and--most intensively--after atorvastatin, but not on lovastatin, which the patient took for about 7 years without any problem. The clinical consequence (to withdraw the drug or not) of these milder statin side effects are discussed.

Aged↗
PubMed2003

Myositis ossificans as a complication of a muscle tendon junction strain of long head of biceps. A case report.

An unusual case of myositis ossificans secondary to a muscle tendon junction (MTJ) strain of long head of biceps in a young athlete is reported. Plain radiographs, ultrasonography and MRI in association with clinical assessment showed the appearance and the evolution of this pathological entity. This case had a resolution of pain and function after 3 months of conservative treatment. At 6 months follow-up, the athlete became asymptomatic and he gradually returned back to his sports activity.

Adolescent↗
PubMed2003

[Non-traumatic myositis ossificans circumscripta in the teres major muscle].

A 49-year-old male presented with a painful progressive swelling in his right axillar region, without further complaints, which had been present for 2 weeks. On radiological examination a peripheral circumferential zone of mineralisation was seen in the right teres major muscle. An incision biopsy specimen showed a lesion of fibroblastic tissue in which areas of osteoid and fragmented lamellar bone tissue, without signs of malignancy. The diagnosis was myositis ossificans circumscripta. This is a rare benign ossifying lesion in skeletal muscles, mostly caused by a trauma and with an average age of occurrence between 20 and 30 years old. It must be differentiated from extra-skeletal osteosarcoma. The pathogenesis is unknown. Because it is a benign and self-limiting disorder, surgical excision is only necessary in case of mechanical hindrance. The patient's swelling partially regressed and he had no further complaints.

Axilla↗
PubMed2003

Pseudomalignant myositis ossificans of the wrist causing compression of the ulnar nerve and artery. A case report.

Myositis ossificans (MO) is a condition characterised by focal, benign and self-limited idiopathic heterotopic bone formation. It is extremely rare in the hand and wrist and may lead to concomitant nerve compression. Because of the rare incidence of pseudomalignant MO at the wrist and hand, we found it of interest to report a case of this condition localised to the wrist. A 31-year-old female patient presented with swelling and pain of her left wrist. The physical examination findings, magnetic resonance imaging and Tc-99m bone scan suggested acute osteomyelitis or a tumoral condition. Incisional biopsy and pathological examination was done. The microscopic findings confirmed that the lesion was pseudomalignant MO. The lesion was removed totally and decompression of the ulnar nerve and artery was achieved. The patient regained full asymptomatic range of motion of all digits and wrist and the numbness of the fourth and fifth digits had subsided at follow-up five months later.

Adult↗
PubMed1992

Myositis ossificans progressiva mimicking ankylosing spondylitis: a case report.

Myositis ossificans progressiva is a rare disorder of young adults characterized by ossification of the connective tissue of the voluntary muscles and ligaments. Although it is trauma-related, up to 40-60% of these patients have no history of previous injury. A young female with marked kyphosis and ankylosis of the spine presented with a recent onset of a rapidly growing painful mass over the anterior aspect of her left shoulder. She received an excisional biopsy but recurrent ossification developed soon after. It then spread to the biceps muscle with subsequent contracture deformities of the shoulder and elbow joints. A plain radiogram of her spine revealed similar characteristics of ankylosing spondylitis. However, the final diagnosis was made by the pathognomonic ectopic ossification of muscles and para-articular soft tissue. Despite poor response of the established constracture, the painful mass did respond well to prednisolone treatment within 2 months, in terms of size and consistency.

Adult↗
PubMed1992

Light and electron microscopic localization of beta-amyloid protein in muscle biopsies of patients with inclusion-body myositis.

In 11 of 11 inclusion-body myositis (IBM) patients, including one hereditary case, vacuolated muscle fibers contained large and multiple small inclusions immunoreactive for beta-amyloid protein (beta AP). All IBM muscle biopsies had characteristic cytoplasmic tubulo-filaments (CTFs) by electron microscopy. None of 14 control muscle biopsies contained the beta AP immunoreactive (IR) inclusions characteristic of IBM. On the light microscopy level, beta AP-IR inclusions colocalized with ubiquitin immunoreactivity. By immunogold electronmicroscopy, beta AP immunoreactivity was localized to a) amorphous, poorly defined structures, b) dense floccular material, c) clusters of loosely packed amyloidlike fibrils 6-8 nm in diameter, and d) poorly defined loose fibrillar structures 6-8 nm in diameter. beta AP immunoreactive structures were often in proximity to CTFs, but CTFs themselves never contained beta AP-IR. Our study provides the first demonstration of beta AP accumulations in abnormal human muscle. This finding suggests that in addition to Alzheimer's disease, Down syndrome, and Dutch-type hereditary cerebrovascular amyloidosis, beta AP may play an important role in the pathogenesis of other diseases, including ones outside the central nervous system, for example, IBM.

Actin Cytoskeleton↗
PubMed1992

[Inclusion body myositis and neuromuscular diseases with rimmed vacuoles].

A retrospective study of 40 patients with various neuromuscular disorders and more than 3 muscle fibers with rimmed vacuoles has been performed. Two subgroups of patients were distinguished according to the presence or absence of inflammatory exudates. In the first group (14 patients), inflammatory exudates were observed and numerous fibers showed partial invasion. Abnormal filamentous inclusions (16-18 nm in diameter) were found by electron microscopy in muscle fibers cytoplasm and/or nuclei. The diagnosis of inclusion body myositis (IBM) was made in these cases. They presented with insidious proximal muscle weakness and were not improved by immunosuppressive therapy. Immunohistological studies demonstrated T lymphocytes predominance, only few natural killer and B lymphocytes. The number of T8 lymphocytes was high in endomysial sites while T4 were more numerous in perivascular exudates. Abnormal membranous expression of class I MHC antigens was observed on muscle fibers lying near the inflammatory exudates. In the second group of cases (26 patients), no inflammatory exudate was observed. This group of neuromuscular diseases with rimmed vacuoles was heterogeneous. In 10 cases, abnormal filamentous inclusions (16-18 nm in diameter) were observed in rimmed vacuoles. However, this ultrastructural feature did not help in distinguishing subgroups. Various neuromuscular disorders were observed in this group: oculopharyngeal muscular dystrophy (12 cases with IBM like filaments in 4 cases), chronic spinal atrophy (5 cases with IBM like filaments in 3 cases), post poliomyelitis syndrome (2 cases with IBM-like filaments in one), muscle glycogenosis with IBM like filaments (2 cases), hereditary limb girdle myopathy or distal myopathy (3 cases) and 1 patient clinically presenting with polymyositis and another with cramps and myalgias. No abnormal sarcolemmal expression of class I MHC was found in this group. The pathogenesis of IBM is discussed. Besides T cell mediated cytotoxicity, denervation may be involved. The nature of the abnormal 16-18 nm filamentous inclusions remains unknown. These filaments are not IBM specific.

Adult↗
PubMed1992

Acute filarial myositis.

An uncommon case of filariasis presenting as acute myositis is described. The patient was treated initially with steroids and antihistamines with no response. Later on with the confirmation of filariasis he was treated with diethyl carbamazine with complete recovery.

Acute Disease↗
PubMedDate not supplied

Myositis ossificans of traumatic origin in the foot.

This case reviews a myositis ossificans of traumatic origin discovered beneath the fifth metatarsal in an adult male. Details of its anatomic appearance are illustrated with the assistance of plane film roentgenography and magnetic resonance imaging. Histologic sections are included to support the diagnosis and present characteristic cellular patterns. A review of the literature including etiology, clinical classification, and diagnostic criteria are also presented.

Aged↗
PubMedDate not supplied

Pictorial essay. Myositis ossificans circumscripta.

Myositis ossificans circumscripta (MOC) is a localized, non-neoplastic, heterotopic ossification within the muscle. Despite advances in medical imaging, it remains difficult to distinguish it from other disorders. As a consequence, a biopsy is frequently performed. We illustrate some common findings and non-specific imaging features of MOC with respect to radiography, computed tomography, bone scintigraphy, ultrasonography, and magnetic resonance imaging. The differentiation among MOC and its mimics is also presented in order to help the radiologists to make an appropriate diagnostic decision.

Diagnosis, Differential↗
PubMed2003

An unusual tumor of the spermatic cord: myositis ossificans.

OBJECTIVES: Tumors of the spermatic cord and epididymis are rare, and their exact incidence is difficult to determine. Ninety percent of extra testicular tumors within the scrotum are found in the spermatic cord, where 30% is malignant (1). METHODS: In this case report we present an unusual spermatic cord tumor, i.e. myositis ossificans (MO). To the best of our knowledge, MO of the spermatic cord has not been reported before in the literature. CONCLUSIONS: MO should be considered in the differential diagnosis of the spermatic cord tumors.

Genital Diseases, Male↗