Differential diagnosis of bacterial myositis in AIDS: evaluation with MR imaging

Article Abstract:

Bacterial myositis is a bacterial infection of the skeletal muscles that causes the muscles to become inflamed and to degenerate. It has been considered a rare disease outside of tropical areas. Bacterial myositis is characterized by a low-grade fever and muscle stiffness in its earlier stages, signs which are difficult to diagnose; the infection may then progress to the point of destroying the muscles. Bacterial myositis has been increasingly recognized in AIDS patients and those infected with HIV, the human immunodeficiency virus. It now appears that bacterial myositis is not rare in this group of people, and while it can be fatal, it can also be treated successfully if recognized in time. This study examined the usefulness of magnetic resonance (MR) imaging to diagnose the disease in 13 HIV-infected patients (11 had AIDS) who were suspected of having bacterial myositis. The patient's records were reexamined to see if there were consistent MR indications of the disease. Results showed that two general patterns existed on the MR images from these patients. The first pattern involved only abnormalities of the muscles, with abscesses with a rim that gave off high-intensity signals and indicated central regions of pus. The second pattern showed both muscle and subcutaneous tissue abnormalities. In the latter patients, the muscle abnormalities were less severe than in those with images showing the first pattern. Results from invasive examination showed that the patients with bacterial myositis followed the first pattern, and those with other disorders followed the second pattern. These results indicate that MR can be useful in diagnosing bacterial myositis in HIV-infected individuals and that lesions present only on the muscles are indicative of the disease, while less severe lesions also affecting surrounding subcutaneous tissue are not indicative of this disease. (Consumer Summary produced by Reliance Medical Information, Inc.)

Bacterial infections, Myositis

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Sports-related muscle injuries: evaluation with MR imaging

Article Abstract:

Muscle pain frequently occurs after strenuous activity. This study examines two forms of muscle pain: pain which begins during exercise, usually referred to as muscle strain; and pain which begins hours or days after strenuous exercise, commonly called delayed-onset muscle soreness. Although there has been a great deal of research dealing with muscle pain, not much is known about its pathology. This is due in part to the inadequacies of current methods for evaluating (by clinical examinations, blood enzyme tests, and imaging procedures) the precise muscle abnormality and the severity and duration of the muscle damage. Researchers used magnetic resonance (MR) imaging to assess damage to muscle tissue in sedentary subjects and marathon runners who experienced muscle strain and delayed-onset muscle soreness. MR imaging provided information not available at clinical examination. Areas of abnormality were identified in individual muscles. The presence of large collections of blood (focal hematoma) and muscle herniation were ruled out; both conditions require surgical repair. MR images also confirmed the belief that exercise-induced muscle pain does not cause long-term muscle damage. MR images demonstrated abnormalities in muscle tissue beyond the time that was indicated by other methods of evaluation. MR images revealed abnormalities up to three weeks longer than the duration of patients' symptoms. This means that MR images provide more accurate information about muscle recovery. In comparing the two groups of subjects it was observed that muscle abnormalities usually involved smaller areas in the marathon runners than in the sedentary group.

Research, Injuries, Physiological aspects, Exercise, Exercise physiology, Muscles, Sports, Sports medicine

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Lung cancer in patients seropositive for human immunodeficiency virus

Article Abstract:

Patients with acquired immunodeficiency syndrome (AIDS) often suffer from a number of complications and infections involving the lungs. These can be very severe and often cause death in these patients. The most frequently seen lung problems in patients infected with human immunodeficiency virus (HIV) are certain pneumonias, tuberculosis, malignant lymphoma (cancer of the B cells of the lymphatic system), and Kaposi sarcoma. It has been thought, but not shown, that HIV-infected patients also are more prone to develop primary lung cancer. Clinical and radiographic records of six HIV patients with lung cancer were reviewed. The patients ranged in age from 30 to 48 years old, with an average of 40 years. All were smokers. Radiography yielded classic images of cancerous lungs. One patient was suffering from pneumonia at the time of the study, but none of the others were suffering from lung problems besides cancer. The findings indicate that HIV-infected patients may be at a higher risk for developing lung cancer than the general population. Although all the patients were smokers, their average age was much lower than that normally seen for lung cancer patients. In addition, the patients were from a group of 500 HIV-infected patients, and the prevalence in this group was 14 times higher than that seen in the general population. With all the attention given to other lung-related problems in HIV-infected patients, lung cancer should not be overlooked as a possibility. (Consumer Summary produced by Reliance Medical Information, Inc.)

Lungs, Lung, Lung cancer

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