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[A case of unilateral recurrent calf myalgia with muscle edema due to venous congestion].
[focal myositis]
We
report
a
38
-
year
-old
man
who
had
three
episodes
of
pain
and
swelling
in
the
right
calf
from
the
age
of
27
years
.
On
each
episode
,
pain
worsened
gradually
,
lasted
for
a
few
months
and
subsided
spontaneously
.
Venography
performed
at
the
first
episode
was
reported
to
be
unremarkable
.
At
the
third
episode
,
physical
examinations
showed
tender
and
hard
muscles
in
the
right
calf
without
findings
of
knee
arthritis
.
The
right
calf
pain
became
stronger
when
standing
than
when
lying
and
on
the
ankle
dorsiflexion
.
Laboratory
examinations
showed
leukocytosis
,
a
slightly
elevated
level
of
CRP
,
and
normal
CK
levels
.
MRI
showed
diffuse
high
intensities
in
the
right
soleus
and
the
lateral
head
of
right
gastrocnemius
on
T
2
-
weighted
images
,
where
CT
showed
slightly
low
densities
.
To
rule
out
focal
myositis
,
the
right
soleus
was
biopsied
.
The
muscle
specimen
showed
perimysial
and
endomysial
edema
,
dilatation
of
venules
and
capillaries
,
and
focal
mononuclear
cell
infiltration
in
the
venule
wall
.
Intermyofibrillar
networks
were
well
preserved
.
There
were
no
necrotic
or
regenerating
fibers
,
nor
sarcolemmal
expression
of
HLA-
ABC
.
On
electron
microscopy
,
the
processes
of
fibroblasts
in
the
endomysium
were
swollen
.
This
case
illustrated
muscle
edema
caused
by
local
venous
congestion
possibly
due
to
venulitis
of
unknown
cause
.
Diseases
Validation
Diseases presenting
"pain"
symptom
achondroplasia
acute rheumatic fever
adrenal incidentaloma
adrenomyeloneuropathy
aniridia
aromatase deficiency
carcinoma of the gallbladder
cholangiocarcinoma
coats disease
congenital diaphragmatic hernia
congenital toxoplasmosis
cushing syndrome
cutaneous mastocytosis
cystinuria
dedifferentiated liposarcoma
dentin dysplasia
dracunculiasis
dystrophic epidermolysis bullosa
epidermolysis bullosa simplex
erdheim-chester disease
erythropoietic protoporphyria
esophageal adenocarcinoma
esophageal carcinoma
esophageal squamous cell carcinoma
fabry disease
familial mediterranean fever
focal myositis
hirschsprung disease
hodgkin lymphoma, classical
holt-oram syndrome
junctional epidermolysis bullosa
kabuki syndrome
kindler syndrome
lamellar ichthyosis
liposarcoma
locked-in syndrome
lymphangioleiomyomatosis
malignant atrophic papulosis
neuralgic amyotrophy
oligodontia
oral submucous fibrosis
papillon-lefèvre syndrome
phenylketonuria
pleomorphic liposarcoma
primary hyperoxaluria type 1
proteus syndrome
pyomyositis
scrub typhus
sneddon syndrome
systemic capillary leak syndrome
thoracic outlet syndrome
trochlear dysplasia
typhoid
von hippel-lindau disease
waldenström macroglobulinemia
well-differentiated liposarcoma
wolf-hirschhorn syndrome
This symptom has already been validated