Objective:We followed patients with facioscapulohumeral muscular dystrophy (FSHD) with sequential examinations over 2 years to investigate whether inflammatory lesions always precede fat replacement, if inflammation can be resolved without muscle degeneration, and if inflammatory lesions in muscle are always followed by fat replacement.Methods:In this longitudinal study of 10 sequential MRI assessments over 2.5 years, we included 10 patients with FSHD. We used MRI with short TI inversion recovery to identify regions of interest (ROIs) with hyperintensities indicating muscle inflammation. Muscle T2 relaxation time mapping was used as a quantitative marker of muscle inflammation. Dixon sequences quantified muscle fat replacement. Ten healthy controls were examined with an MR scan once for determination of normal values of T2 relaxation time.Results:We identified 68 ROIs with T2-elevation in the FSHD patients. New ROIs with T2-elevation arising during the study had muscle fat content of 6.4–33.0% (N=8) and lesions that resolved, 47.0–78.0% (N=6). ROIs with T2-elevation had a higher increase in muscle fat content from visits 1 to 10 (7.9±7.9%) compared to ROIs with normal muscle T2 relaxation times (1.7±2.6%; p<0.0001). Severe T2-elevations were always followed by an accelerated replacement of muscle by fat.Conclusions:Our results suggest that muscle inflammation starts in mildly affected muscles in FSHD, is related to a faster muscle degradation, and continue until the muscles are completely fat replaced.

NCT02759302.

Summary A one‐year‐old female trotter was examined for an enlarging mass on the proximoventral aspect on the right side of the proximal cervical area. On clinical and ultrasonographic examination the mass was found to be a fluid filled cavity of approximately 8 cm in diameter surrounded by a capsule. The right lobe of the thyroid gland was closely related to the mass. The mass and the right thyroid gland were surgically excised. Histological examination revealed an ultimobranchial cyst. This is the first description of the diagnosis and treatment of a thyroid cystic abnormality related to the fifth branchial pouch (ultimobranchial body) in a horse.

The compression bandage reduced proximal diffusion and lymphatic drainage of contrast material causing it to stay localised around the injection site. Use of compression bandages could thus result in increased specificity of the nerve block and potentially prolong its effect.