Guest guest Posted October 9, 2001 Report Share Posted October 9, 2001 Hi Lynn.... Here's something to read while your relaxing... MRI guided muscle biopsy confirmed polymyositis diagnosis in a patient with interstitial lung disease J Lampaa, I Nennesmob, H Einarsdottirc, I Lundberga a Department of Rheumatology, Karolinska Hospital, Stockholm, Sweden, b Department of Pathology, Huddinge Hospital, Stockholm, Sweden, c Department of Radiology, Karolinska Hospital, Stockholm, Sweden Correspondence to: Dr J Lampa, Rheumatology Unit, Karolinska Hospital, S-171 76 Stockholm, Sweden jonlam@... Accepted for publication 15 August 2000 Idiopathic inflammatory myopathies, such as polymyositis (PM), may present with general symptoms such as fever and fatigue and only minimal muscle weakness, making it difficult to make a definite diagnosis and provide adequate treatment. Here a case is described in which interstitial lung disease was the first and most prominent manifestation of PM. Later, when muscle weakness became apparent and inflammatory muscle disease was suspected the first muscle biopsy was non-diagnostic. However, magnetic resonance imaging (MRI) scans of the clinically weak thigh muscles showed high signal on T2 weighted images, suggesting muscle inflammation more proximal to the first biopsy site. A second biopsy at this site disclosed typical histopathological findings for myositis. After treatment with prednisolone in combination with cyclophosphamide both pulmonary and muscle function improved. CONCLUSION: MRI scans of muscles may be helpful in selection of a site for muscle biopsy in patients with suspected inflammatory myopathy when a first muscle biopsy turns out to be negative. Additionally, patients with interstitial lung disease of unknown cause should be tested for muscular function to exclude an associated inflammatory muscle disorder. ------------------- Answer to your question.... it does matter where they take the biopsy since the inflamed muscle can be missed and you'll have to have it done again. The inflammation is patchy. My hands were really bad before I had my diagnosis. I could hardly open nor lift anything. My thumbs were so sore. Is it just the end of your index finger or the whole finger? Does the cold affect your fingers? I know about the swelling... I went down 51 lbs while in the hospital and it only took 11 days. Now that's weight loss...LOL Boy oh boy, all systems go and you're on your way to finally getting this all behind you. Hope tomorrow is better for you. Take care, Vicki Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 10, 2001 Report Share Posted October 10, 2001 Hi Lynn, At least you're inching toward a definite diagnosis and toward some relief (I hope) from all these discomforts and the questions. You mentioned that one of your legs seems worse than the other: I know that most rheumys tell us that myositis is symmetrical, referring to the pain, weakness and damage, but I know of cases (myself included) where the problems are worse on one side than the other. My left side was damaged about 50% more than the right side and no one knows why. We'll all keep you in our thoughts as you go through the tests on your road to feeling better! Annette Getting Closer! Evening Everyone! Hope y'all are feeling mighty good tonight! May you be relaxing and just taking it easy! Surgeon's office called...they changed instructions to take the muscle on my left side because I had the EMG on my right side!! See there are smart doctors here!! Now, question - My left leg is pretty good compared to the rest of me. Is myositis consistent...are some muscles worse than others? Ohh, I guess it doesn't matter. One of the docs advised I stop taking Celebrex since it has been linked to some heart problems...and seeing how this muscle problem is cooking...I have to find out for sure! My CPK is 2238, so it hasn't changed a bit, may have elevated just a tad. I'm also a little anemic! My hands hurt so bad, kids, I just don't know what to do. They are peeling...my right hand index finger is purple and swollen...I couldn't get gas in my car cause I couldn't get the gas cap open (last week I couldn't release my parking brake!) And swollen...I bet I'm retaining 20 lbs. of water (just wait until I start the Pred. etc. eh?? Sigh) It's just a painful day. But all my pre-op work is done and all systems go! Lynn ===== ~*~*~Each mighty oak at one time was a nut who stood her ground.*~*~*~*~ __________________________________________________ Quote Link to comment Share on other sites More sharing options...
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