Gastrocnemius myositis in a patient with inflammatory bowel disease

A young woman with long-standing inflammatory bowel disease presented with a tender left gastrocnemius myositis in association with an exacerbation of her disease. Muscle biopsy showed a chronic inflammatory cell infiltrate and atrophic muscle fibres, but no granulomata or vasculitis, and her symptoms responded to high-dose steroids. Twelve months later she underwent subtotal colectomy for troublesome symptoms and incidentally was discovered to have an adenocarcinoma of the sigmoid colon. Myositis without granulomata has not been reported previously in either Crohn's disease or ulcerative colitis.