[A case of chronic multifocal myositis]

Area of Science:

• Neurology
• Muscle Physiology
• Pathology

Background:

• Presents a unique case of a 61-year-old male with slowly progressive, asymmetrical muscle atrophy.
• Symptoms began at age 56, initially affecting the right shoulder and left arm, later progressing to thighs.

Observation:

• Notable muscle wasting in the trapezius, proximal upper and lower extremities, with asymmetry.
• Muscle strength was relatively preserved despite significant atrophy.
• Elevated creatine kinase and myoglobin levels, with normal nerve conduction studies.

Findings:

• Electromyography revealed combined myopathic and neuropathic changes.
• Computed tomography (CT) showed asymmetrical muscle atrophy and patchy low-density areas.
• Muscle biopsy demonstrated fiber size variation, necrosis, regeneration, central nuclei, fibrosis, and mononuclear inflammatory infiltration.

Implications:

• Highlights the diagnostic complexity of asymmetrical myopathies.
• Suggests a potential inflammatory or degenerative process affecting skeletal muscles.
• Underscores the importance of integrated diagnostic approaches including imaging and biopsy for rare muscle disorders.