Recurrent Bilateral Focal Myositis

Abstract

This report describes a rare case of recurrent bilateral focal myositis and its successful treatment via methotrexate. A 38-year-old man presented myalgia of the right gastrocnemius in May 2005. Magnetic resonance imaging showed very high signal intensity in the right gastrocnemius on short-tau inversion recovery images. A muscle biopsy revealed inflammatory CD4+ cell-dominant myogenic change. Focal myositis was diagnosed. The first steroid treatment was effective. Tapering of prednisolone, however, repeatedly induced myositis relapse, which progressed to multiple muscle lesions of both lower limbs. Initiation of methotrexate finally allowed successful tapering of prednisolone, with no relapse in the past 4 years.

Recurrent Migrating Focal Myositis: A Pediatric Case Report

“…3 Bilateral relapses have only been reported in adults. 7 Clinical evolution is benign; however, a diagnosis of FM may signal an underlying disease. In a 2018 study, FM was associated with immune-mediated inflammatory diseases (IMIDs) in up to 32% of patients, as well as with neoplasia in 24% of patients and radiculopathy in 11% of patients.…”