Journal List > J Rheum Dis > v.23(6) > 1064295

Lee, Kwon, Seo, and Kim: Acute Myositis of the Tibialis Anterior Muscle after Performance of 108 Prostrations

Abstract

Exercise-induced muscle damage (EIMD) can be caused by novel or unaccustomed exercise resulting in a temporary decrease in muscle function, increased muscle soreness and swelling, and an increase in muscle proteins in blood. A 38-year-old female presented with a 2-week history of bilateral lower leg pain and swelling that developed suddenly after performing 108 prostrations. Fat-suppressed contrastenhanced T1-weighted magnetic resonance imaging showed bilateral symmetric high signal intensity of the tibialis anterior muscles. Our patient was diagnosed with acute myositis and treated with naproxen. History of physical exertion and acute onset of typical clinical findings of myositis were key elements in the diagnosis. Acute myositis related to exercise is a common and self-limiting condition which fully resolves after 2 to 3 weeks. However, other causes of myositis should be excluded in patients with atypical clinical features.

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Figure 1.
Magnetic resonance imaging of both lower legs. T1-weighted images (A, coronal and B, axial view) showing iso-signal intensity (arrows). Fat-suppressed contrastenhanced T1-weighted images (C, D) showing bilateral symmetric high signal intensity of the tibialis anterior muscles and of the anterior portion fascia (arrowheads).
jrd-23-382f1.tif
Figure 2.
Biopsy of the left tibialis anterior muscle shows marked endomysial fibrosis (A) and lymphocytes infiltration (B). (C) Basophilic regenerating fibers are shown. (D) Necrotic myofiber are infiltrated by marked lymphocytes and histiocytes (H&E stain, A: ×200; B∼ D: ×400).
jrd-23-382f2.tif
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