Rice-Grain Calcifications: A Classic Sign of Muscular Cysticercosis

Muscular cysticercosis is an uncommon manifestation of Taenia solium infection, usually discovered incidentally, that produces characteristic elongated intramuscular calcifications on plain radiographs. We describe an 85-year-old man admitted with a viral respiratory infection complicated by respiratory failure, who developed myalgia disproportionate to the infection. Plain radiographs of the lower limbs, obtained to investigate the myalgia, revealed numerous "rice-grain" calcifications parallel to the muscle fibers, consistent with the patient's known history of cysticercosis. Recognizing this pattern as representing chronic, inactive disease avoided unnecessary investigations and antiparasitic treatment. The myalgia was not attributable to the calcified lesions and was instead attributed to a combination of the patient's advanced age, hospitalization-related immobilization, and the viral infection itself, deep vein thrombosis having been excluded. Symptoms resolved within one week with paracetamol alone. This case highlights the importance of correctly attributing incidental radiographic findings so as not to delay recognition of the true cause of a patient's symptoms.