M Krusche1, N Ruffer2, T Kubacki2, J Matschke3, I Kötter2. 1. Rheumatologie, Klinische Immunologie, Nephrologie, Asklepios Klinik Altona, Paul-Ehrlich-Str. 1, 22763, Hamburg, Deutschland. martinkrusche@gmx.de. 2. Rheumatologie, Klinische Immunologie, Nephrologie, Asklepios Klinik Altona, Paul-Ehrlich-Str. 1, 22763, Hamburg, Deutschland. 3. Institut für Neuropathologie, Universitätsklinikum Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Deutschland.
Abstract
BACKGROUND: Myalgia is a common but unspecific set of symptoms that may be caused by orthopedic, neurological and internal medical conditions, often resulting in a diagnostic challenge. Muscular polyarteritis nodosa (PAN) is a rare differential diagnosis of myalgia with elevated serological inflammatory markers. OBJECTIVE: Based on three clinical cases and the literature this review describes the essential clinical and diagnostic features of muscular PAN. RESULTS: Muscular PAN typically presents with immobilizing myalgia confined to the lower limbs and elevated serological inflammatory markers but often normal creatine kinase (CK) levels. Contrast-enhanced magnetic resonance imaging of the affected muscles, which can often mimic myositis, and muscle biopsy provide the relevant histological findings that lead to the diagnosis of a vasculitis. CONCLUSION: With respect to own experiences and the reviewed literature, muscular PAN should be considered as a possible diagnosis in cases of myalgia with elevated inflammatory markers but normal CK levels and a lack of further symptoms typical for vasculitis.
BACKGROUND:Myalgia is a common but unspecific set of symptoms that may be caused by orthopedic, neurological and internal medical conditions, often resulting in a diagnostic challenge. Muscular polyarteritis nodosa (PAN) is a rare differential diagnosis of myalgia with elevated serological inflammatory markers. OBJECTIVE: Based on three clinical cases and the literature this review describes the essential clinical and diagnostic features of muscular PAN. RESULTS: Muscular PAN typically presents with immobilizing myalgia confined to the lower limbs and elevated serological inflammatory markers but often normal creatine kinase (CK) levels. Contrast-enhanced magnetic resonance imaging of the affected muscles, which can often mimic myositis, and muscle biopsy provide the relevant histological findings that lead to the diagnosis of a vasculitis. CONCLUSION: With respect to own experiences and the reviewed literature, muscular PAN should be considered as a possible diagnosis in cases of myalgia with elevated inflammatory markers but normal CK levels and a lack of further symptoms typical for vasculitis.
Authors: M Khellaf; M Hamidou; C Pagnoux; M Michel; J M Brisseau; X Chevallier; P Cohen; L Guillevin; B Godeau Journal: Ann Rheum Dis Date: 2006-10-26 Impact factor: 19.103
Authors: R W Lightfoot; B A Michel; D A Bloch; G G Hunder; N J Zvaifler; D J McShane; W P Arend; L H Calabrese; R Y Leavitt; J T Lie Journal: Arthritis Rheum Date: 1990-08