Unilateral temporal myositis heralding polymyositis: ultrasonographic and elastographic findings. Case report.

Abstract

Temporal myositis is a rare inflammatory disease of the temporal muscle. We report a case of unilateral temporal myositis, in which a polymyositis was diagnosed two years thereafter. Although focal myositis may rarely herald polymyositis, isolated temporal myositis preceding inflammatory myopathies has not been described, to our knowledge. In the setting of a temporal pain and swelling, ultrasonography may help in diagnosis, biopsy guidance, disease extension, and progression assessment. Further studies are necessary to establish the role of elastography in differentiating between muscle inflammation and hypertrophy.

Isolated unilateral temporalis muscle hypertrophy: first case in an Indo-Aryan

“…1 To our knowledge, the only predictive causes from the reported cases are stress 3 and bruxism. 9 Other factors that have been linked to masticatory muscle hypertrophy are parafunctional jaw habits, Takayasu's disease, polymyositis 4 , temporomandibular dysfunction, myopathic diseases, rheumatic disorders, idiopathic muscle enlargement and neoplasms such as rhabdomyosarcoma or lymphomas. When it came to clinical presentation, visible swelling was seen in all cases -most of which were painless.…”

“…11 Additional tests include stomatological/oral examinations to check for signs of bruxism or other dental anomalies 3,4 ; magnetic resonance angiography to see vessel abnormalities; and electromyography for signs of polyphasia, dystonia, etc. 5 As for laboratory investigations, they were either not done or not reported in a few cases 6,12 but most had a focus on ESR and CRP 2,4,5,6,7 as infl ammatory markers and in one case serum creatine kinase was checked for possible muscle damage such as in rhabdomyolysis. 3 Three main treatment methods are still practiced until now and can be intriguingly seen even in the fi rst three cases of IUTMH reported ( Table 1).…”

“…12 Supportive treatment has the widest range of applications including systemic muscle relaxants 7 , Amitriptyline (antidepressant) 8 , Acetaminophen/paracetamol 5 and even corticosteroids and disease modifying antirheumatic drugs. 4 Btx-A has been successfully used in four cases since 2000 3,6,9 however Isaac 12 reported that the muscle recovers when new neuro-muscular junctions form after a period of two to four months. Hence repeated intramuscular injections of Btx-A are necessary.…”

Myositis Ossificans Traumatica of the Temporal Muscle: a Case Report and Literature Review Emphasizing Radiographic Features on Computed Tomography and Magnetic Resonance Imaging

“…The literature search found 53 English language articles reporting cases of MO [1][2][3][4][5][6][7][8][9][10][11][12]15,16,, in which ten cases were bilateral [3,9,12,33,34,47,50]. MO Temporalis was reported in 12 cases [12,15,16,[18][19][20][21]23,[28][29][30]54], in which one case was bilateral [12]. The medial pterygoid muscles were the most affected muscle [1,3,5,8,26,27,32,35,38,39,[42][43][44][45][46]48,…”

“…The summarised data regarding the muscles involved are available in Figure 5. CT examinations were performed in all cases except three [11,29,57]. Ultrasonography (USG) was performed in two cases [20,27,29] and positron emission tomographic scans (PET) were used in two cases [4,49].…”