Polyarteritis nodosa isolated to muscles-A case series with a review of the literature

Semin Arthritis Rheum. 2020 Jun;50(3):503-508. doi: 10.1016/j.semarthrit.2019.12.002. Epub 2019 Dec 28.

Abstract

Muscular polyarteritis nodosa where disease is isolated to skeletal muscle is a rare and often poorly recognised clinical entity. Patients typically present with fever and severe muscle pain limiting ability to ambulate without rise in creatine kinase. Often there is a significant delay between presentation and diagnosis, which requires histological confirmation. Musculoskeletal MRI is a sensitive investigation that can lead to timely biopsy and improve diagnostic yield. Early diagnosis of this condition is essential as patients typically respond favourably to corticosteroid treatment. Here we report 4 cases of muscular polyarteritis nodosa and review the reported literature.

Keywords: Muscular; Myositis; Polyarteritis nodosa; Vasculitis.

Publication types

  • Case Reports
  • Letter
  • Review

MeSH terms

  • Adult
  • Aged
  • Anti-Inflammatory Agents
  • Antirheumatic Agents / administration & dosage
  • Female
  • Humans
  • Immunoglobulins, Intravenous / administration & dosage
  • Immunologic Factors / administration & dosage
  • Lower Extremity / diagnostic imaging
  • Male
  • Methotrexate / administration & dosage
  • Middle Aged
  • Muscle, Skeletal / diagnostic imaging
  • Muscle, Skeletal / pathology*
  • Myalgia / etiology*
  • Polyarteritis Nodosa / diagnosis*
  • Polyarteritis Nodosa / drug therapy
  • Polyarteritis Nodosa / physiopathology

Substances

  • Anti-Inflammatory Agents
  • Antirheumatic Agents
  • Immunoglobulins, Intravenous
  • Immunologic Factors
  • Methotrexate