title: [Extreme atrophy of the shoulder muscles in juvenile ankylosing spondylitis as a (misleading) main symptom].
abstract: An extreme unilateral muscular atrophy of the shoulder and upper arm region was a symptom of juvenile ankylosing spondylitis in a 20-year-old female patient. No pathological patterns were found in electromyographic, bioptic, and tomographic (CT, NMR) investigations. The muscular atrophy was caused by a shoulder arthritis with severe erosive damage. The false assumption of a neurological disorder and the disregard of anamnesis and low back pain delayed for several years an accurate diagnosis. After the onset of an arthritis of hip joints a collagen disease with myositis was supposed falsely in spite of normal electromyographic results. The unusual muscular atrophy around the shoulder joint probably must be interpreted as a consequence of reflex inhibition and partly due to inactivity. A real myositis seems to not be probable, because newer investigations in contrast to earlier findings show no evidence for inflammatory muscle disease in ankylosing spondylitis.
authors.affiliation: Klinik für Physikalische Medizin, Balneologie und Rheumatologie der Universität Giessen in Bad Nauheim.
authors.forename: M
authors.initials: M
authors.lastname: Berliner
authors.forename: K L
authors.initials: KL
authors.lastname: Schmidt
mesh_terms: D000328:Adult; D003951:Diagnostic Errors; D005260:Female; D006801:Humans; D009133:Muscular Atrophy / Q000000981:diagnostic imaging*; D012446:Sacroiliac Joint / Q000000981:diagnostic imaging; D012785:Shoulder Joint / Q000000981:diagnostic imaging*; D013167:Spondylitis, Ankylosing / Q000150:complications* / Q000000981:diagnostic imaging; D014057:Tomography, X-Ray Computed
vernacular_title: Hochgradige Atrophie der Schultermuskulatur bei juveniler ankylosierender Spondylitis als (fehlgedeutetes) Leitsymptom.