Muscle morphology and enzymes in proximal and distal muscle groups of lower limb from patients with corticosteroid treated rheumatoid arthritis: the relationship to maximal isokinetic muscle strength.

Abnormal morphological and enzymatic patterns in the lateral vastus muscle have been found in women with corticosteroid treated rheumatoid arthritis. By means of biopsies from the lateral heads of right gastrocnemius muscles, the histology and enzyme activities were compared with those found in right vastus lateralis biopsies. The findings were correlated with isometric and isokinetic strength of the plantar flexors. The relative occurrence of type I fibres in the gastrocnemius muscle was 46.4 +/- 18.7 (SD) %, which is significantly higher than found in the vastus lateralis [35.7 +/- 13.3 (SD) %] (P less than 0.03). The relatively lower percentage of type II fibres in the gastrocnemius muscle was due to a relatively low percentage of type II A fibres [mean 27.9 +/- 16.4 (SD) %] (P less than 0.05). The area of type I fibres in the gastrocnemius muscle was 26.1 X 10(2) +/- 10.0 (SD) micron 2, which is 74% of the mean area for type I fibres found in the vastus lateralis (P less than 0.01). The area of type II fibres in the gastrocnemius was 14.9 X 10(2) +/- 7.1 (SD) micron 2, which is 77% of the mean area for type II fibres found in the vastus lateralis. The isokinetic muscle strength of the plantar flexors in corticosteroid treated patients with rheumatoid arthritis was reduced to less than 50% at all angular velocities when compared with healthy women. The same difference was found in the knee extensors.(ABSTRACT TRUNCATED AT 250 WORDS)