title: Recurrent Bilateral Focal Myositis.
abstract: This report describes a rare case of recurrent bilateral focal myositis and its successful treatment via methotrexate. A 38-year-old man presented myalgia of the right gastrocnemius in May 2005. Magnetic resonance imaging showed very high signal intensity in the right gastrocnemius on short-tau inversion recovery images. A muscle biopsy revealed inflammatory CD4+ cell-dominant myogenic change. Focal myositis was diagnosed. The first steroid treatment was effective. Tapering of prednisolone, however, repeatedly induced myositis relapse, which progressed to multiple muscle lesions of both lower limbs. Initiation of methotrexate finally allowed successful tapering of prednisolone, with no relapse in the past 4 years.
authors.affiliation: Division of Rheumatology, Department of Internal Medicine, St. Marianna University School of Medicine, Japan.
authors.forename: Hiroko
authors.initials: H
authors.lastname: Nagafuchi
authors.forename: Hiromasa
authors.initials: H
authors.lastname: Nakano
authors.forename: Seido
authors.initials: S
authors.lastname: Ooka
authors.forename: Yukiko
authors.initials: Y
authors.lastname: Takakuwa
authors.forename: Hidehiro
authors.initials: H
authors.lastname: Yamada
authors.forename: Mamoru
authors.initials: M
authors.lastname: Tadokoro
authors.forename: Sadatomo
authors.initials: S
authors.lastname: Shimojo
authors.forename: Shoichi
authors.initials: S
authors.lastname: Ozaki
mesh_terms: D000328:Adult; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D008279:Magnetic Resonance Imaging; D008297:Male; D008727:Methotrexate / Q000627:therapeutic use; D018482:Muscle, Skeletal / Q000473:pathology; D009220:Myositis / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000473:pathology*; D011239:Prednisolone / Q000627:therapeutic use; D012008:Recurrence
chemical_list: D000893:Anti-Inflammatory Agents; D007166:Immunosuppressive Agents; D011239:Prednisolone; D008727:Methotrexate