Focal myositis (FM) is a rare disease characterized by focal inflammatory enlargement in a single skeletal muscle, and usually is cured without medication.1 It is important to distinguish FM from other diseases, especially localized nodular myositis, in which multiple nodular myositis could often develop into a generalized inflammatory disease, polymyositis.2
A healthy man, aged 43 years, experienced left femoral muscle pain and enlargement in November 1997. A muscle biopsy from his left quadriceps femoris revealed inflammatory myopathy. His symptoms gradually improved without medication. In January 2004, he recognized again the gradual left femoral swelling without other complaints. In April 2004, his left thigh became 5 cm thicker than his right one, with a mild pushing pain, and he was admitted to our hospital. He had no muscle weakness. The result of a blood test showed no particular abnormality, including serum creatine kinase level, erythrocyte sedimentation rate, and antinuclear antibody and anti-Jo1 antibody levels. T2-weighted magnetic resonance imaging revealed increased signal intensity within the left quadriceps femoris with gadolinium enhancement (Figure, A). The result of a second muscle biopsy from the left quadriceps femoris also showed infiltration of mononuclear cells and myopathic changes (Figure, B). Gallium citrate Ga 67 scintigraphy showed gallium uptake only in the left quadriceps femoris (Figure, C). The patient was diagnosed as having a relapse of FM, and his symptoms gradually improved without medication.
T2-weighted magnetic resonance imaging revealed increased signal intensity (arrows) within the left quadriceps femoris (A), the result of a muscle biopsy from the left quadriceps femoris showed prominent infiltration of mononuclear cells and muscle fiber degeneration (a higher-power view is given as an inset in the lower right) (B), and gallium citrate Ga 67 scintigraphy showed focal gallium uptake in the left quadriceps femoris (C). In panel B, the bar denotes 100 μm. L indicates left.
Thank you for submitting a comment on this article. It will be reviewed by JAMA Neurology editors. You will be notified when your comment has been published. Comments should not exceed 500 words of text and 10 references.
Do not submit personal medical questions or information that could identify a specific patient, questions about a particular case, or general inquiries to an author. Only content that has not been published, posted, or submitted elsewhere should be submitted. By submitting this Comment, you and any coauthors transfer copyright to the journal if your Comment is posted.
* = Required Field
Disclosure of Any Conflicts of Interest*
Indicate all relevant conflicts of interest of each author below, including all relevant financial interests, activities, and relationships within the past 3 years including, but not limited to, employment, affiliation, grants or funding, consultancies, honoraria or payment, speakers’ bureaus, stock ownership or options, expert testimony, royalties, donation of medical equipment, or patents planned, pending, or issued. If all authors have none, check "No potential conflicts or relevant financial interests" in the box below. Please also indicate any funding received in support of this work. The information will be posted with your response.
Some tools below are only available to our subscribers or users with an online account.
Download citation file:
Web of Science® Times Cited: 1
Customize your page view by dragging & repositioning the boxes below.
More Listings atJAMACareerCenter.com >
Enter your username and email address. We'll send you a link to reset your password.
Enter your username and email address. We'll send instructions on how to reset your password to the email address we have on record.
Athens and Shibboleth are access management services that provide single sign-on to protected resources. They replace the multiple user names and passwords necessary to access subscription-based content with a single user name and password that can be entered once per session. It operates independently of a user's location or IP address. If your institution uses Athens or Shibboleth authentication, please contact your site administrator to receive your user name and password.