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Focal myositis of the calf following S1 radiculopathy.
[focal myositis]
To
determine
the
clinical
,
pathological
,
and
magnetic
resonance
imaging
(
MRI
)
characteristics
and
outcome
of
focal
myositis
of
the
calf
associated
with
S
1
radiculopathy
.
C
ase
report
and
systematic
review
of
literature
using
a
literature
review
based
on
a
Medline
search
from
1950
to
2006
.
Only
cases
with
myositis
documented
on
muscle
biopsy
examination
were
included
.
Six
patients
,
including
ours
,
with
focal
myositis
of
the
calf
associated
with
chronic
S
1
radiculopathy
have
been
reported
.
Creatine
phosphokinase
levels
were
high
in
5
cases
.
MRI
provided
evidence
of
global
hypertrophy
and
inflammatory
signals
affecting
the
whole
of
1
or
several
muscle
heads
of
the
triceps
.
Electromyography
confirmed
the
existence
of
neurogenic
abnormalities
with
nearly
constant
spontaneous
activity
.
Histological
analysis
of
muscle
tissue
showed
an
inflammatory
infiltrate
and
denervation
lesions
.
Progression
was
slow
and
corticosteroid
treatment
had
little
effect
.
There
was
no
extension
toward
a
diffuse
form
.
Hypertrophy
in
a
denervated
muscle
should
lead
the
physician
to
consider
a
diagnosis
of
localized
secondary
myositis
.
On
the
other
hand
,
localized
hypertrophic
myositis
is
suggestive
of
previous
radicular
distress
in
the
territory
concerned
.
The
identification
of
this
condition
in
focal
myositis
makes
it
possible
to
avoid
unnecessary
additional
investigations
and
escalation
of
treatment
.
Diseases
Validation
Diseases presenting
"escalation of treatment"
symptom
focal myositis
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