Myositis (peds): Difference between revisions
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{{Peds top}} [[myositis]] | |||
==Background== | ==Background== | ||
*Influenza is one of the most common causes of viral myositis | *[[Influenza]] is one of the most common causes of viral myositis | ||
*[[Rhabdo]] is unusual but has been reported. | *[[Rhabdo]] is unusual but has been reported. | ||
==Clinical Features== | ==Clinical Features== | ||
*Patients usually have a history of recent illness (fever, URI symptoms | *Patients usually have a history of recent illness ([[fever (Peds)|fever]], [[URI]] symptoms, etc) | ||
*Significant | *Significant [[myalgia]]s as starting to improve from constitutional symptoms | ||
**Most commonly lower legs | **Most commonly lower legs | ||
**Can have pain and tenderness in other muscle groups (thighs, arms) | **Can have pain and tenderness in other muscle groups (thighs, arms) | ||
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==Differential Diagnosis== | ==Differential Diagnosis== | ||
{{Myalgia DDX}} | {{Myalgia DDX}} | ||
{{Pediatric hip DDX}} | |||
==Evaluation== | ==Evaluation== | ||
*Total CK | |||
*Total | *[[UA]] (for myoglobin) | ||
*UA (for myoglobin) | |||
==Management== | ==Management== | ||
*Supportive | |||
*Fluids ([[IVF]] or oral) | |||
*[[Analgesia]]; avoid [[NSAIDs]] | |||
==Disposition== | ==Disposition== | ||
*Discharge with close outpatient follow up if CPK <3,000 and able to orally hydrate <ref>https://pedemmorsels.com/benign-acute-childhood-myositis/</ref> | |||
==See Also== | ==See Also== | ||
*[[Myositis]] | |||
==External Links== | ==External Links== | ||
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==References== | ==References== | ||
<references/> | <references/> | ||
[[Category:Rheumatology]] [[Category:Pediatrics]] | |||
Latest revision as of 23:28, 5 November 2025
This page is for pediatric patients. For adult patients, see: myositis
Background
- Influenza is one of the most common causes of viral myositis
- Rhabdo is unusual but has been reported.
Clinical Features
- Patients usually have a history of recent illness (fever, URI symptoms, etc)
- Significant myalgias as starting to improve from constitutional symptoms
- Most commonly lower legs
- Can have pain and tenderness in other muscle groups (thighs, arms)
- Usually look well, but will sometimes walk with wide gait and on their toes
- When lying in bed, will often keep toes pointed with pain in calves upon dorsiflexion
Differential Diagnosis
Myalgia
- Infection:
- Viral infection (e.g. Influenza)
- Bacterial infection
- Spirochete infection (E.g. Dengue fever; Trichinella)
- Drugs:
- Statins
- Bisphosphonates
- Corticosteroids
- Ciprofloxacin
- Clofibrate
- Colchicine
- Chloroquine
- Emetine
- Aminocaproic acid
- Zidovudine
- Bretylium
- Penicillamine
- Drugs causing hypokalemia
- Metabolic disorders:
- Vitamin D deficiency
- Mitochondrial myopathy
- Scurvy
- Osteomalacia
- Fibromyalgia
- Endocrine:
- Polymyalgia rheumatica
- Rhabdomyolysis
- Myositis
- Systemic lupus erythematosus
- Rheumatoid arthritis
- Inclusion body myositis
- Sarcoidosis
- Scleroderma
- Sjögren’s syndrome
- Psychiatric (e.g. somatic manifestations of depression)
- Domestic abuse
- Crush injury
- Lyme disease
- Ehlers-Danlos syndrome(hypermobility syndrome)
- HIV myopathy
- Hypophosphatemia
- Hypokalemia
- Hypothermia
- Prolonged immobility
- Strenuous exercise (overuse) or heat stroke
- Seizure
- Severe volume contraction
- Alcoholism
- Muscular dystrophy
- Duchenne
- Becker
- Limb-girdle
- Facioscapulohumeral
- Myotonic dystrophy
- Myotonia congenita
- Compartment syndrome; Muscle infarction
- Neuropathic
- Chronic fatigue syndrome
- Vasculitis
- Sarcocystosis
- Spinal stenosis
- Diabetic lumbosacral plexopathy
Pediatric limp
Hip Related
- Acute rheumatic fever
- Developmental dysplasia of hip
- Femur fracture
- Juvenile idiopathic arthritis
- Legg-Calve-Perthes disease
- Septic arthritis of the hip (peds)
- Lyme disease arthritis
- Slipped capital femoral epiphysis
- Transient (toxic) synovitis
- Osteosarcoma
Other Causes of Limping
- Developmental dysplasia
- Fracture
- Toddler's fracture
- Tillaux fracture, adolescent
- Neoplasm:
- Leukemia
- Ewings
- Osteogenic sarcoma
- Metastatic neuroblastoma
- Osteomyelitis
- Myositis
- Other:
Evaluation
- Total CK
- UA (for myoglobin)
Management
Disposition
- Discharge with close outpatient follow up if CPK <3,000 and able to orally hydrate [1]