Subacute Fibrosing Nodular Polymyositis: Nodular Variant of Polymyositis with Pronounced Contractures of “Woody” Firm Muscles and Painless Intramuscular Nodules: Report of a Case

Valery M Kazakov, Dmitry I Rudenko, Tima R Stuchevskaya, Vladislav O Kolynin and Natalya V Shuleshova

Department of Neurology, First Pavlov State Medical University of St. Petersburg, Russia

^*Correspondance to: Valery Kazakov 

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Abstract:

A man aged 64 with localized nodular myositis which was one of the clinical features of fibrosing polymyositis is described. In the clinical picture one could find pronounced muscle contractures of upper arm and especially of leg muscles with sharp limitation of movement’s range in large joints, together with “woody” firmness of the limb muscles with painless tumor-like swellings within the muscles of upper arms and thighs. EMG showed abnormal spontaneous electrical activity, very short motor unit potentials and increased incidence of polyphasic potentials. Muscle biopsy showed pronounced increase of the fibrous tissue around muscle fascicles in perimysium exclusively, this was combined with massive inflammatory cell infiltrates, and diffuse inflammatory cell infiltration with small foci inside endomysium. Increased variability in the fiber’s size, as well as atrophy, focal degenerative changes and necrosis of some muscle fibres was also evident. Treatment with prednisolone in combination with cyclophosphane caused decrease of both nodule’s size and firmness of muscles, accompanied by some increase of joint movement’s range.

Keywords:

Fibrosing myositis; Localized nodular myositis; Muscle and joints contractures; Inflammation; Polymyositis

Cite the Article:

Kazakov VM, Rudenko DI, Stuchevskaya TR, Kolynin VO, Shuleshova NV. Subacute Fibrosing Nodular Polymyositis: Nodular Variant of Polymyositis with Pronounced Contractures of “Woody” Firm Muscles and Painless Intramuscular Nodules: Report of a Case. Clin Case Rep Int. 2018; 2: 1074.