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Answer to Case of the Week: Feb 28-Mar 6, 2008
12 year old recent diagnosis of lupus presents with pain and weakness in lower extremities

 


Patient being treated with steroids and hydrochloroquine.
Abnormal muscle signal intensity involving the thigh muscles and pelvis. No evidence of avascular necrosis
Diagnosis: Biopsy proven Steroid induced Myopathy

Myositis can be secondary to: 

1. Steroids

 2. Lupus 

3. Critical illness myopathy

4. Hydroxychloroqine

 Biopsy of the left thigh muscle (1-5) showed atrophy involving the type 2 fibers.

No necrosis, vasculitis, inflammation or other degenerative changes are seen.

Selective type 2 fiber atrophy in this patient represents steroid-induced myopathy.

No depletion of myosin is observed on immunostain and critical illness myopathy was excluded.

Residents Submitting Correct Diagnosis - Case of the Week
Radiology
Pediatrics
VCU Resident
  		• Maria Torrone
  		• Jonathan Ha
  		• Kenny Uy
    Others
  		• Dishant ShahUnited States of America
  		• Jeffrey VandeSandUnited States of America
  		• Nagendar RaoIndia
  		• Gitanjali BajajIndia
  		• Greg KlischUnited States of America
  		• Vidula GodhamgaonkarUnited Kingdom
    Disclaimer: This information is intended solely for resident review of presented cases which may or may not be pathologically proven. Information is derived from a number of published sources of varying reliability and does not represent original research from the institution. It is not intended to be comprehensive and should therefore not substitute for careful review of the literature.