“ This is an idiopathic inflammatory myopathy with deposition of complement or inflammatory infiltrate in the skeletal muscle and subcutaneo...
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This is an idiopathic inflammatory myopathy with deposition of complement or inflammatory infiltrate in the skeletal muscle and subcutaneous tissue. It affects children and adults. It is associated with malignant neoplasms in up to 25%, particularly genitourinary, gynaecological, oesophageal, lung and melanoma. There is also an increased risk of venous thromboembolism and myocardial infarction.
PLAIN FILM
- Non-specific subcutaneous calcification.
- Sheet-like calcifications along fascial or muscle planes of the proximal large muscles are less common; however, these are pathognomonic.
HIGH-RESOLUTION CT (HRCT)
• 67% have interstitial lung disease.
• Most commonly there is subpleural consolidation (bronchiolitis obliterans organising pneumonia [BOOP]).
• BOOP may progress to subpleural honeycombing and usual interstitial pneumonia.
• Bronchiolitis (‘tree in bud’), ill-defined airspace opacification suggests chronic aspiration pneumonia.
MRI
• Muscle oedema early, followed by calcification and atrophy.
• High T2 signal intensity seen in the muscles suggests oedema, enhancement seen on T1 post-contrast.
• Fatty infiltration late in the disease (high signal on T1 and T2).
Dermatomyositis. Pelvic x-ray demonstrating sheet-like calcification along muscular/fascial planes, particularly above the left hip.
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