Muscle cramps in the calf as presenting symptom of sarcoidosis

Article Abstract:

Sarcoidosis, a disorder which can affect multiple organs and tissues, is characterized by deposition of granulomas, growths containing granular white blood cells and epithelial cells, which ordinarily cover outer body surfaces. The disease can be diffuse and its cause is unknown. Muscles may be involved in up to 80 percent of affected patients, who may have symptoms such as weakness, aching, or rarely, palpable nodules, or else the condition may not produce symptoms. A case is described of a 63-year-old woman who developed pain in the left calf muscles due to a palpable nodule, which was the initial symptom of sarcoidosis. The patient had a sudden onset of cramping pain which increased with walking and which prevented her from standing flat on the foot. The calf pain was constant at night, and she had morning stiffness, but no other problems. The nodule was just under an inch in diameter at the edge of the Achilles tendon, above the ankle. Erythrocyte (red blood cell) sedimentation rate was elevated, a nonspecific indicator of inflammatory or other disease, and levels of angiotensin converting enzyme were slightly elevated, suggestive in this case of sarcoidosis. Biopsy of the nodule showed granulomas, and the patient was treated with rest and a nonsteroidal anti-inflammatory medication. This symptomatic treatment was only partly effective. Injection of the nodule with an anti-inflammatory steroid completely abolished pain. One month after diagnosis, X-rays showed swelling of lymph nodes. The sedimentation rate improved within three months, while nodes and enzyme levels returned to normal after two years. Usually, symptomatic muscle disease in sarcoidosis begins with weakness and is progressive and severe. This report indicates that muscle pain may be a chief symptom in sarcoidosis and should be considered in patients with inexplicable muscle pain. (Consumer Summary produced by Reliance Medical Information, Inc.)

Causes of, Muscle cramps, Sarcoidosis

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Magnetic resonance imaging of the shoulder in patients with rheumatoid arthritis

Article Abstract:

Magnetic resonance imaging (MRI), which allows the visualization of internal body parts by the absorbance of radiowaves, is a sensitive method for examining the muscles and bones. A common site for the occurrence of rheumatoid arthritis (RA) is the shoulder. RA can involve the joints, the clavicle or collar bone, the bursae, the tendons known as rotator cuff tendons, and the surrounding muscles. MRI was used to detect abnormalities in the shoulders of 18 patients. The MRI procedure was able to detect bony abnormalities and soft tissue lesions; the latter included joint effusion and muscular atrophy or wasting. The soft tissue lesions were not visible with conventional radiography (X-ray imaging). However, conventional radiography is more useful than MRI for examining the acromioclavicular joint, the joint between the scapula and clavicle, two of the bones forming the shoulder. Early detection of shoulder involvement in RA is important so that physiotherapy can be initiated to prevent further, irreversible damage. MRI is a sensitive method of diagnosis which allows identification and grading of abnormalities in the shoulder joint of patients with RA. (Consumer Summary produced by Reliance Medical Information, Inc.)

Evaluation, Rheumatoid arthritis, Arthritis, Magnetic resonance imaging, Shoulder, Imaging

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Teenager with an irritable hip, anaemia and malaise

Article Abstract:

Children with a spinal joint disease called juvenile spondylarthropathy (SpA) may have inflammatory symptoms in joints and organs of the body other than the spine. In addition to the criteria used for adults, standardized guidelines used to diagnose children with juvenile SpA would be helpful. Doctors examined an 11-year old boy who had pain in his left groin, left shoulder, both wrists, both hips, both ankles, and lower back. He developed sores in his mouth and on his feet, lost weight, had bloody loose stools, and was anemic. A biopsy of the large intestine and esophagus showed an inflammation in these sections. Chemical tests revealed a lactate deficiency. The physicians diagnosed the patient with juvenile SpA and treated him with tolmetine and exercise.

Case studies, Spondyloarthropathies

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