title: [Oculomotor muscles involvement revealing dermatomyositis in a patient with rheumatoid arthritis].
abstract: BACKGROUND
  Oculomotor muscles (OMM) involvement in dermatomyositis (DM) and in rheumatoid arthritis (RA) is unusual. The DM always leads to OMM inflammation, whereas the RA particularly leads to tenosynovitis of the superior oblique muscle referred to as the Brown syndrome.
  
  
  METHODS
  The patient is a 43-year-old woman who gives a 17-year-history of severe seropositive RA with bilateral coxite. She was hospitalized for acute painful proptosis. The clinical examination revealed an orbital erythema and a muscular rhizomelic weakness. The muscular enzymes were increased. The orbital CT revealed in the right side, an enlargement of the superior rectus muscle that was enhanced after intravenous injection, which is compatible with myositis involvement. The muscular biopsy practiced at the level of the calf showed the specific histological signs of the DM. This orbital involvement was resolved with a high dose of corticosteroids.
  
  
  CONCLUSIONS
  Our observation has the specificity of associating RA with DM with an involvement of the superior rectus muscle, which is due to the DM rather than the RA.
authors.affiliation: Service de rhumatologie, EPS Monastir 5000, Tunisie.
authors.forename: M
authors.initials: M
authors.lastname: Younes
authors.forename: I
authors.initials: I
authors.lastname: Béjia
authors.forename: A
authors.initials: A
authors.lastname: Moussa
authors.forename: M
authors.initials: M
authors.lastname: Touzi
authors.forename: S
authors.initials: S
authors.lastname: Zrour
authors.forename: F
authors.initials: F
authors.lastname: Haddada
authors.forename: A
authors.initials: A
authors.lastname: Zakhama
authors.forename: N
authors.initials: N
authors.lastname: Bergaoui
mesh_terms: D000328:Adult; D001172:Arthritis, Rheumatoid / Q000150:complications* / Q000188:drug therapy / Q000473:pathology; D001706:Biopsy; D003882:Dermatomyositis / Q000150:complications* / Q000188:drug therapy / Q000473:pathology; D005094:Exophthalmos / Q000209:etiology; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D008776:Methylprednisolone Hemisuccinate / Q000627:therapeutic use; D009801:Oculomotor Muscles / Q000473:pathology*; D009886:Ophthalmoplegia / Q000209:etiology* / Q000473:pathology; D016896:Treatment Outcome
chemical_list: D005938:Glucocorticoids; D008776:Methylprednisolone Hemisuccinate