case_images: PMC11259473_01
case_images: A (Lumbar spine T2 Axial) & B (Coronal TRIM) - Myositis and edema seen in bilateral paraspinal, thigh and psoas muscles (red arrows).
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case_images: MRI cervical, and thoracic spine with and without contrast were unremarkable. MRI of the thigh and lumbar spine showed myositis with extensive edema involving bilateral thighs, paraspinal, and psoas muscles (Fig. 1).
case_images: A-Scattered basophilic myofibers with prominent nucleoli indicative of myofiber fiber regeneration, a histologic feature of active myocyte injury (H&E stain, scale indicates 50 um); B-Subtle chronic-appearing inflammatory infiltrates, composed of monocytes and lymphocytes, in the subfascial and epimysial adipose tissue (H&E stain, scale indicates 50 um); C-Focally prominent histiocytic component in the inflamed adipose tissue (CD68 immunoperoxidase stain, scale indicates 50 um).
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case_images: A thigh muscle biopsy revealed nonspecific inflammation showing some myofiber atrophy with scattered myofiber necrosis, endomysial and epimysial inflammation with fat necrosis but no vasculitis or amyloidosis (Fig. 2).
case_images: A (Coronal view) & B (Sagittal view) - Resolution of previously seen myositis in the thigh muscles (red arrows).
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case_images: Repeat MRI of the thigh showed resolution of previously seen myositis (Fig. 3).