J Rheum Dis.  2016 Dec;23(6):382-385. 10.4078/jrd.2016.23.6.382.

Acute Myositis of the Tibialis Anterior Muscle after Performance of 108 Prostrations

• Lee SY
• Kwon MJ
• Seo YI
• Kim HA

• KMID: 2364692
• DOI: http://doi.org/10.4078/jrd.2016.23.6.382

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 contrast-enhanced 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.

Keyword

Myositis; Exercise; Inflammation; Magnetic resonance imaging

MeSH Terms

Adult
Diagnosis
Female
Humans
Inflammation
Leg
Magnetic Resonance Imaging
Muscle Proteins
Muscles
Myalgia
Myositis*
Naproxen
Physical Exertion
Muscle Proteins
Naproxen

Figure

• 

  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).

• 

  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).

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