case_images: PMC7792877_01
case_images: Magnetic resonance imaging with hyper intensity in anterior and posterior compartment in both hip and thigh (right > left) in short tau inversion recovery
case_images: ABR-9-65-g001.jpg
case_images: PMC7792877_01_ABR-9-65-g001.jpg
case_images: F1
case_images: Magnetic resonance imaging (MRI) showed hyperintensity in the anterior and posterior compartment in both thighs (right > left) and also in paraspinal muscles in short-tau inversion recovery [Figure 1].
case_images: Magnetic resonance neurography with multi located collection in right gluteus muscle and right femur neck osteomyelitis
case_images: ABR-9-65-g002.jpg
case_images: PMC7792877_01_ABR-9-65-g002.jpg
case_images: F2
case_images: Thereafter, magnetic resonance neurography (MRN) was ordered, which showed multilobulated collection in the right gluteus muscle and right femur neck osteomyelitis; however, lumbosacral nerve roots were normal [Figure 2].
case_images: Magnetic resonance imaging with Gadolinium with enhancement of paraspinal muscles in second visit
case_images: ABR-9-65-g003.jpg
case_images: PMC7792877_01_ABR-9-65-g003.jpg
case_images: F3
case_images: In second lumbosacral MRI with Gadolinium enhancement of paraspinal muscles was reported [Figure 3].
case_images: Magnetic resonance imaging in hip, thigh with hyperintensity in proximal muscles particularly in right side with avascular necrosis in right femur neck in second visit
case_images: ABR-9-65-g004.jpg
case_images: PMC7792877_01_ABR-9-65-g004.jpg
case_images: F4
case_images: In MRI of hip and thigh, hyperintensity in proximal muscles, particularly in the right side with avascular necrosis in the right femur neck, was noticed [Figure 4].
case_images: Magnetic resonance imaging in leg with hyperintensity in anterior and posterior muscles in leg
case_images: ABR-9-65-g005.jpg
case_images: PMC7792877_01_ABR-9-65-g005.jpg
case_images: F5
case_images: In addition, hyperintensity in anterior and posterior muscles in leg MRI was presented [Figure 5].
case_images: (a) Muscle biopsy right vastus lateralis with severe necrosis (a and b) and left sural nerve biopsy with mild wall thickening in vessels without infiltration (c and d)
case_images: ABR-9-65-g006.jpg
case_images: PMC7792877_01_ABR-9-65-g006.jpg
case_images: F6
case_images: In muscle biopsy, severe necrosis was displayed, and in left sural nerve biopsy, a mild wall thickening in vessels without infiltration with no evidence of vasculitis was shown [Figure 6].
case_images: Facial image of patient showing blue line on gums
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case_images: PMC7792877_01_ABR-9-65-g007.jpg
case_images: F7
case_images: In retrograde examination, blue line in gum of the teeth was detected [Figure 7], and the patient was referred to poisoning specialist, and penicillamine (500 mg q8h) with pyridoxine (50 mg daily) for 8 months was started for him.