scholarly journals Focal Myositis of the Deltoid Muscle: The Role of Magnetic Resonance Imaging for Diagnosis

2021 ◽  
Vol 11 (10) ◽  
Author(s):  
Matthew Ricks ◽  
Vasantha Kumar Ramsingh ◽  
Andrew Cole ◽  
George Cox

Introduction:Focal myositis is a rare condition first described by Heffner et al., in 1977, as a self-limiting condition of unknown aetiology. It presents as an inflammatory pseudo tumour in skeletal muscle and can present diagnostic difficulty, being commonly mistaken for tissue of vascular, inflammatory, or neoplastic origin. Diagnosis is traditionally confirmed by muscle biopsy. We present a case where magnetic resonance imaging (MRI) was used to confirm the diagnosis without need for biopsy. Case Presentation: A 19-year year-old female presented with a two2-year history of intermittent swelling of the deltoid associated with pain and tenderness to palpation. . There was no history of trauma or systemic illness. . She was symptomatic with pain, swelling, and tenderness over the left deltoid with no restriction in range of movement of the shoulder or neck. Plain radiographs were normal and MRI magnetic resonance imaging showed diffuse odeamatousedematous signal changes on the proton density weighted sequence within the deltoid muscle and no plexiform neurofibroma. Nerve conduction and electromyography studies were within normal limits excluding an axillary nerve lesion. The patient underwent extensive screening for connective tissue disorders and creatine kinase and lactate dehydrogenase levels were within limits. The patient underwent neuromuscular specialist review confirming that this appeared to be a rare case of focal myositis in the deltoid. . The serial MRI scans confirmed resolution of the condition. Conclusion: Focal myositis of the deltoid is a rare cause of shoulder pain. . We have shown that sequential MRI scanning can obviate the need for muscle biopsy, which has historically been required for diagnostic confirmation. The MRI appearance on the proton density weighted sequence showed diffuse odeamatousedematous signal changes and no plexiform neurofibroma within the deltoid and is a description that has not been previously used for this rare diagnosi

2019 ◽  
Vol 1 ◽  
pp. 2-6
Author(s):  
Asad Naqvi ◽  
Timothy Ariyanayagam ◽  
Mir Akber Ali ◽  
Akhila Rachakonda ◽  
Hema N. Choudur

Objective: The objective of this study was to outline a novel unique concept of secondary impingement of the muscles, myotendons, and tendons of the rotator cuff from hypertrophy as a result of strength training exercises. Methods: In this retrospective observational study, 58 patients were referred for an magnetic resonance imaging (MRI) by the orthopedic surgeon to the radiology department over a period of 1½ years. All patients gave a history of strength training exercises and presented with clinical features of rotator cuff impingement. Results: We identified features of hypertrophy of rotator cuff muscles, myotendons, and tendons in 12 of these 58 patients. This was the only abnormality on MRI. The hypertrophy of rotator cuff muscles and tendon bulk completely filling the subacromial space to the point of overfilling and resulting in secondary compressive features. Conclusion: Rotator cuff impingement is a common phenomenon that can occur with various inlet and outlet pathological conditions. However, rotator cuff impingement may also result from muscle and tendon hypertrophy from strength training regimens. Hypertrophy of the rotator cuff can result in overfilling of the subacromial space, leading to secondary impingement, which we have termed as “pseudo-impingement.”


Author(s):  
Hongzhang Zhu ◽  
Shi-Ting Feng ◽  
Xingqi Zhang ◽  
Zunfu Ke ◽  
Ruixi Zeng ◽  
...  

Background: Cutis Verticis Gyrata (CVG) is a rare skin disease caused by overgrowth of the scalp, presenting as cerebriform folds and wrinkles. CVG can be classified into two forms: primary (essential and non-essential) and secondary. The primary non-essential form is often associated with neurological and ophthalmological abnormalities, while the primary essential form occurs without associated comorbidities. Discussion: We report on a rare case of primary essential CVG with a 4-year history of normal-colored scalp skin mass in the parietal-occipital region without symptom in a 34-year-old male patient, retrospectively summarizing his pathological and Computer Tomography (CT) and magnetic resonance imaging (MRI) findings. The major clinical observations on the CT and MR sectional images include a thickened dermis and excessive growth of the scalp, forming the characteristic scalp folds. With the help of CT and MRI Three-dimensional (3D) reconstruction techniques, the characteristic skin changes could be displayed intuitively, providing more evidence for a diagnosis of CVG. At the 5-year followup, there were no obvious changes in the lesion. Conclusion: Based on our observations, we propose that not all patients with primary essential CVG need surgical intervention, and continuous clinical observation should be an appropriate therapy for those in stable condition.


Author(s):  
Ceylan Colak ◽  
Jennifer A. Bullen ◽  
Vahid Entezari ◽  
Michael Forney ◽  
Hakan Ilaslan

Author(s):  
Ceylan Colak ◽  
Jennifer A. Bullen ◽  
Vahid Entezari ◽  
Michael Forney ◽  
Hakan Ilaslan

Neurosurgery ◽  
2011 ◽  
Vol 68 (4) ◽  
pp. E1170-E1174 ◽  
Author(s):  
Kazim Raza ◽  
Chandrasekaran Kaliaperumal ◽  
Michael Farrell ◽  
John A. O'Dwyer ◽  
Christopher Pidgeon

Abstract BACKGROUND AND IMPORTANCE: We report the case history of solitary hypoglossal paraganglioma in a 64-year-old woman. The surgical difficulties encountered in the removal of this challenging tumor are discussed and as a literature review provided. CLINICAL PRESENTATION: A 64-year-old woman presented with a short history of dysphonia, occasional dysphagia, tinnitus, altered taste, and unilateral left-sided tongue wasting. On examination, there was left lower motor hypoglossal paralysis. Imaging showed a discrete enhancing lobulated mass, measuring 2 × 2 cm, in the region of the hypoglossal nerve extending into the hypoglossal canal suggestive of hypoglossal paraganglioma. A left dorsolateral suboccipital craniotomy was performed with the patient in the sitting position. The hypoglossal nerve appeared to be enlarged, and the jugular foramen was normal. Complete surgical debulking of the tumor was not attempted because of its vascular nature. The nerve was decompressed, and neuropathology confirmed a low-grade paraganglioma arising from the hypoglossal nerve. The patient was scheduled to receive stereotactic radiation for further management. CONCLUSION: When a case of solitary hypoglossal paraganglioma is encountered in clinical practice, the aim of management should be mainly focused on achieving a diagnosis and preserving the hypoglossal nerve function. If there is evidence of vascularity in the lesion noted on magnetic resonance imaging, a preoperative angiogram should be obtained with a view for embolization. We decompressed the hypoglossal canal and achieved good improvement in the patient's symptoms. We recommend stereotactic radiosurgery for remnant and small hypoglossal tumors and regular follow-up with magnetic resonance imaging scans.


2017 ◽  
Vol 53 (1) ◽  
pp. 59-63
Author(s):  
Kathleen Ann Bonawandt ◽  
Jason M. Berg ◽  
Richard J. Joseph ◽  
Joseph D. Stefanacci

ABSTRACT A 7 yr old female spayed Yorkshire terrier was referred to the author's institute for a 5 mo history of recurrent cervical spinal pain. Neurologic examination did not reveal any deficits. Hematologic and serum analyses were within normal limits. Thoracic radiographs that incorporated the cervical spine did not show structural abnormalities. Magnetic resonance imaging of the cervical spine demonstrated a contrast enhancing, intradural extramedullary lesion at the level of the C2 vertebra. Hemilaminectomy was performed, during which a long, narrow nematode was visualized upon opening of the dura mater. The parasite was alive when removed during surgery, and the dog recovered with complete resolution of symptoms. The parasite was submitted and confirmed as a male adult Dirofilaria immitis. This is a novel case of an intradural D. immitis infection in the dog with a magnetic resonance imaging description of spinal D. immitis.


2004 ◽  
Vol 18 (2) ◽  
pp. 80-87 ◽  
Author(s):  
Archie Heddings ◽  
Mehmet Bilgen ◽  
Randolph Nudo ◽  
Bruce Toby ◽  
Terence McIff ◽  
...  

Objectives. It is widely accepted that peripheral nerve repairs performed within 6 weeks of injury have much better outcomes than those performed at later dates. However, there is no diagnostic technique that can determine if a traumatic peripheral nerve injury requires surgical intervention in the early postinjury phase. The objective of this article was to determine whether novel, noninvasive magnetic resonance imaging techniques could demonstrate the microstructure of human peripheral nerves that is necessary for determining prognosis and determining if surgery is indicated following traumatic injury. Methods. Ex vivo magnetic resonance imaging protocols were developed on a 9.4-T research scanner using spin-echo proton density and gradient-echo imaging sequences and a specially designed, inductively coupled radio frequency coil. These imaging protocols were applied to in situ imaging of the human median nerve in 4 fresh-frozen cadaver arms. Results. Noninvasive high-resolution images of the human median nerve were obtained. Structures in the nerve that were observed included fascicles, interfascicular epineurium, perineurium, and intrafascicular septations. Conclusion. Application of these imaging techniques to clinical scanners could provide physicians with a tool that is capable of grading the severity of nerve injuries and providing indications for surgery in the early postinjury phase.


Sign in / Sign up

Export Citation Format

Share Document