A visible and palpable cause of backache

Serhan, E; Newton, Phillip J.; Fitzgerald, Richard; Jassim, Iftikhar A.

doi:10.1136/ard.59.3.164

Cited by 6 publications

(2 citation statements)

References 11 publications

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“…The literature search yielded 280 articles, of which 52 articles (Fig. 3) reporting 67 cases were included for review; these comprised case series of 2 to 10 patients 2–6 and many case reports, 7–53 thus including the index case reported by us; 68 cases of primary tuberculous myositis were analyzed. A majority were Asian (69%), and mean age at presentation was 38.7 (±18.6) years (Supplemental Table 1, http://links.lww.com/RHU/A221).…”

Section: Results Of the Systematic Reviewmentioning

confidence: 99%

Primary Tuberculous Myositis—Report of a Case and Systematic Review of Literature in the Last 25 Years

et al. 2020

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M ycobacterium tuberculosis infects approximately 1.7 billion people in the world and causes disease in 10 million annually. Musculoskeletal tuberculosis accounts for 2% to 5% of cases, generally presenting as Pott's spine or large joint arthritis 1 ; the involvement of muscle by tubercle bacilli, referred to as tuberculous myositis, is rare. Muscle involvement can occur either due to hematogenous spread (primary) or as a result of extension from a contiguous site (secondary); the former being less common. 2 We report a case of primary tuberculous myositis and review all cases published in the last 25 years. CASE REPORTA 49-year-old man was admitted with swelling and dullaching pain over the right gluteal region, fever, and loss of appetite for 6 months. Three years prior to the current presentation, he had been diagnosed with dermatomyositis and treated with corticosteroids and azathioprine; these drugs were tapered and stopped after 2 years. With a possibility of relapse, corticosteroids were restarted 1 month before his admission.On examination, a localized tender swelling was present over the right gluteal area and posterior thigh, extending to the knee. Magnetic resonance imaging of this region revealed active myositis of the gluteal muscle and muscles in the posterior compartment of the right thigh (Figs. 1A, B). Positron emission tomographycomputed tomography showed uptake in these muscles, and an image-guided biopsy was performed. This revealed granulomatous inflammation on histopathology (Fig. 2), and a cartridge-based nucleic acid amplification test GeneXpert MTB/RIF (Cepheid, Sunnyvale, CA) detected M. tuberculosis. Computed tomography of the thorax did not show any pulmonary tuberculosis; however, tuberculin skin test was positive. Antitubercular therapy was started with isoniazid, rifampicin, ethambutol, and pyrazinamide for 2 months, followed by isoniazid, rifampicin, and ethambutol for 8 months. The fever resolved within 2 weeks, and over the next few months, the swelling subsided, and the patient gained weight. At 1 year, he was found to be asymptomatic and disease-free. METHODS FOR SYSTEMATIC REVIEWWe carried out a search in PubMed (MEDLINE), Scopus, EMBASE, and Web of Science, using the words "tubercular myositis," "tubercular pyomyositis," "tuberculous myositis," or "tuberculous pyomyositis." This review was restricted to articles in English language that were published between January 1995 and December 2019. Abstracts and full texts of relevant articles were examined by 2 authors (H.S., V.D.), and those articles that described cases of primary tuberculous myositis confirmed by microbiological tests (or on histopathology) were included for review. The outcome of cases was noted, factors associated with death analyzed, and odds ratios (ORs) (95% confidence intervals [CIs]) calculated. Analysis was done by GraphPad Prism (version 8 for Windows, La Jolla, CA).

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Section: Results Of the Systematic Reviewmentioning

confidence: 99%

Primary Tuberculous Myositis—Report of a Case and Systematic Review of Literature in the Last 25 Years

et al. 2020

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“…High suspicion is needed to diagnose at the earliest and to prevent complications especially in endemic areas. 10,11 Treatment is based on antitubercular therapy (susceptible to organism) with a minimum of four drugs for a prolonged period. Isoniazid, rifampicin, pyrazinamide and ethambutol regimen is used.…”

Section: Discussionmentioning

confidence: 99%

Primary tuberculous myositis of sternocleidomastoid and anterior scalene muscle: A report of three cases

Priya¹,

Angral²,

Sood³

et al. 2021

IJASHNB

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Pulmonary tuberculosis is the most common form of tuberculosis reported in India. Primary tuberculous myositis is a rare entity and involvement of sternocleidomastoid and anterior scalene muscle together has rarely been reported in literature. This diagnosis is very frequently missed due to its rarity and atypical clinical presentation, which leads to delay in treatment. A high suspicion index and a prompt intervention is a must for such a rare clinical presentation of extra pulmonary tuberculosis. This entity should be considered as differential diagnosis for the neck swellings. Here we present a report of three cases of primary tubercular pyomyositis of sternocleidomastoid muscle with one case involving anterior scalene as well.

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