Myositis is a disease that occurs for a number of reasons and leads to the occurrence of an inflammatory process in muscle tissue. Depending on what caused the ailment, it is classified into various types. One group of pathological conditions is conditionally harmless and treatable, while the other, causing serious disorders in the body, can lead to death. In the article we will consider the main issues related to this pathology. Here, the reader will find out in which cases myositis occurs, what treatment forecasts exist for ossifying myositis today, how to protect yourself from this disease.
What it is?
Myositis includes a whole range of diseases, which are based on the inflammatory process that occurs in the muscles. A key symptom indicating a possible occurrence of the disease in the body is muscle pain, aggravated by movement or palpation.
Pathology occurs against the background of a previous infection or hypothermia, and can also develop as a result of
autoimmune diseases, injuries, bruises, etc.
The causes of the disease are conditionally classified into two groups:
- endogenous - which occur inside the body;
- exogenous - causes from the outside.
To endogenous include:
- autoimmune diseases such as lupus erythematosus, rheumatoid arthritis, etc .;
- infections of various nature - enterovirus, typhoid, flu;
- diseases caused by the activity of parasites in the human body (echinococcosis, trichinosis);
- intoxication of the body.
Exogenous causes are injuries, hypothermia, periodic muscle tension caused by any activity. Myositis is considered an occupational disease of musicians, athletes.
Types
By the origin of the disease, by the nature of its course and other signs, myositis is classified into infectious, purulent and parasitic categories. Toxic and traumatic varieties are also known. Polymyositis (ossifying myositis) is a pathology with the most severe course and ambiguous consequences. This disorder is a disease of connective tissue and, in turn, is classified into:
- traumatic ossifying myositis;
- progressive ossifying myositis;
- neuromyositis.
Traumatic ossifying myositis (the symptoms of the disease will be discussed later) is an inflammatory disease that occurs against a background of severe trauma or repeated repeated microtraumas. Pathology is localized in the articular ligaments and subsequently leads to the occurrence of ossification in a problem place. Successfully treated surgically.
Progressive ossifying myositis (the symptoms of the disease we will describe below) is a genetic disease caused by a mutation of a certain gene, leading to severe disorders in the body and ultimately to human death. It is considered very rare (no more than 200 cases known to world medical practice).
Neurotrophic myositis occurs against the background of injuries of large nerve trunks or the spinal cord. Most often, the pathology develops in the knee or hip joint.
Neuromyositis
As noted earlier, it infects intramuscular nerve fibers. It happens as follows. The inflammatory process leads to the destruction of muscle cells, resulting in the release of various kinds of substances that have a toxic effect on nerve fibers. The nerve sheath is gradually destroyed, which leads to damage to the axial nerve cylinder.
Signs of neuromyositis are:
- decreased or increased sensitivity in the area of localization of pathology;
- pain
- muscle weakness;
- joint pain.
Destruction of the sheath of nerve fibers causes a change in the sensitivity of the skin. This can be manifested by numbness or tingling, which are accompanied by progressive pain. At first, the pain syndrome is moderate, but it intensifies even with minor loads. The pain causes breathing, turning or tilting the body, movement of the limbs. Later, she makes herself felt even at rest. Often with pathology, a symptom of tension occurs, when palpation of the muscles in tension becomes very sensitive.
Progressive form of the disease
The second type of polymyositis due to genetic disorders is progressive ossifying myositis. Symptoms of the pathology are almost impossible to eliminate, because it is considered incurable. With progressive ossifying myositis, ossification of muscles, tendons and ligaments occurs. The disease occurs almost spontaneously and over time covers a large group of muscles. A fatal outcome is inevitable, as the ossification of the pectoral and swallowing muscles makes it impossible for a person to eat and breathe. Progressive ossifying myositis has a different name - progressive ossifying fibrodysplasia (FOP).
The pathology is based on the occurrence of an inflammatory process in the
tendons, ligaments and muscles, which ultimately leads to their ossification. The back muscles (wide, trapezius) undergo the greatest initial changes in ossifying myositis. What are the consequences of this disease? Serious disturbances in the functioning of the musculoskeletal system, stiffness of movements, inability to properly eat and breathe - all this significantly reduces the quality of life of the patient. As a rule, the process begins in children at the age of ten and progresses over the years, however, the majority of patients die before they reach the ten-year mark.
Only in 2006, thanks to studies conducted by a group of scientists from the University of Pennsylvania, a gene was identified whose mutation leads to severe pathology. Today, experts are developing mutation blockers in the gene.
Symptoms of FOP
As mentioned above, FOP occurs in childhood. The possible formation of the disease in the baby can be indicated by several signs that occur mostly with ossifying myositis. What are the most obvious symptoms of the disease?
With a 95% probability, a pathology in a child can be diagnosed if one or more phalanges of the big toe are curved inward. In some cases, the finger does not have a joint. Most often, boys suffer from progressive myositis. The symptom of an illness in early infancy is painful palpation of the muscles, while they are quite dense, tense.
Another sign of pathology is swelling of the soft tissues of the head, which could occur with minor bruises or scratches, insect bites. However, in the presence of FOP, puffiness does not respond to drug therapy and does not go away within a month. Under the skin in the area of the back, forearm or neck, seals up to ten centimeters in size can also occur.
Initially, FOP affects the muscles of the neck, back, head, and later descends into the abdominal and femoral sections of the musculature. However, the disease never affects the muscle tissue of the heart, diaphragm, tongue, peri-ocular muscles.
The disease is often confused with oncology and try to remove the hardening that has arisen, which does not lead to recovery, but provokes the rapid growth of "unnecessary" bones.
Treatment
Unfortunately, to date, progressive ossification myositis is practically impossible to eliminate, and the therapy used is ineffective. There are no proven methods for the prevention of FOP. With the discovery of the mutating gene, it became possible only to study the processes of the disease. Treatment methods are developed in the laboratory and are not used in medical practice. In addition, possible experimental therapies must be seriously evaluated in terms of dosage and duration of treatment.
Specialists who are engaged in precisely ossifying myositis work in the United States, at the McKay Laboratory at Pennsylvania Federal University. Dr. med. Frederic Kaplan leads the scientific work.
In the initial stages of the disease, therapy includes anti-inflammatory drugs, ascorbic acid, vitamins A and B, biostimulants. In severe cases of pathology, steroid hormones are used, although their effectiveness is also not proven.
Physiotherapy leads to some improvements - ultrasound, electrophoresis. These procedures give a resolving and analgesic effect. A minimum intake of calcium-containing foods should be maintained, and any intramuscular injection should be avoided. Surgery and bone removal is pointless.
Traumatic ossifying myositis
Localized traumatic ossifying myositis is a disease that leads to bone formation as a result of acute injuries - dislocations, fractures, sprains, or as a result of repeated minor trauma, for example, athletes or musicians.
The pathology is based on hemorrhage in muscle tissue. Most often, ossificates are formed in the gluteal, femoral and brachial muscles. Some time after the injury, the first symptoms of the pathology appear. Compaction is formed in the muscle, which grows rapidly and is painful on palpation. After several weeks, the compaction transforms into an ossification of an indefinite form, which limits the mobility of a nearby joint. Then the pain gradually disappears. Young people are affected, most of them men with developed muscles.
Only after the radiograph is reliably diagnosed with "traumatic ossifying myositis." X-ray photo above. The result of the x-ray indicates that in the area of the lesion there is a peculiar light “cloud” that does not have clear boundaries. The ossification arising from pathology at first does not have a definite shape, but later acquires a structure and clear contours.
Traumatic ossifying myositis: treatment
How to eliminate the disease? Traumatic ossifying myositis has favorable prognosis for treatment. Immediately after the injury, the application of a plaster cast for up to two weeks is indicated. After detecting the first signs of the disease and establishing a diagnosis, it is necessary to apply light heat, radon baths, X-ray therapy, electrophoresis, light therapeutic exercises. At the same time, massage, paraffin, and an electric field cannot be used for medicinal purposes.
After the x-ray revealed the presence of a cloud shadow, it is still possible to prevent the development of the disease and reverse the process. Under the influence of hormones, resorption of the formation occurs. Steroid injections are given topically. Often, Hydrocortisone is used in combination with Novocaine.
After a few months after the injury, when the ossification is already formed, conservative treatment does not make sense. Six months later, they resort to surgery - ossiophyte together with the capsule is removed.
There are some conditions, the fulfillment of which will lead to a positive outcome of therapy and the absence of relapse - the operation should be atraumatic, it is necessary to use an electric knife, carefully suture the wound cavity, and in the postoperative period carry out the prescribed preventive measures.
Diagnosis of ossifying myositis
Identification of the disease begins with a study of the clinical picture. A conversation with the patient allows us to determine the presence in the life of the latter ailments that could become a trigger for the development of myositis. Often, the pathology occurs due to cystitis, osteomyelitis, erysipelas of the skin. Viruses, bacteria and fungal infections also provoke the development of myositis. The disease is formed after injuries, muscle cramps, hypothermia. Long-term stress on certain muscle groups also leads to pathology.
As noted earlier, with ossifying myositis, pain occurs. Patients often complain of aching pain and muscle weakness. Palpation of the affected areas of the body helps to determine the presence / absence in the muscles of gravity and nodules.
The disease can develop under the influence of toxic substances, for example, with alcoholism and drug use. Taking certain medications also leads to muscle damage.
Survey process
In addition to collecting an anamnesis and examination to confirm the diagnosis, an x-ray is performed to detect ossification. Sometimes computed tomography and radioisotope examination of affected muscles can be performed.
The presence of myositis in the body is indicated by characteristic changes in the general analysis of blood. Another method of laboratory research is conducting rheumatic tests - tests that help determine the nature of the disease and exclude autoimmune diseases, as well as identify the intensity of the inflammatory process.
Indicators of rheumatic tests indicate various conditions of the body. For example, C-reactive protein is a marker of the acute phase of the inflammatory process. Antistreptolysin-O is a substance that is produced in the body during streptococcal infection. Its presence indicates rheumatism or rheumatoid arthritis. Rheumatic factor is an antibody that is produced in the body by autoimmune pathologies.
A morphological study in the diagnosis of myositis is a biopsy - taking biomaterial for analysis and thoroughly studying it. The main task is to determine structural changes in the muscles and connective tissue.
Prevention
Prevention of ossifying myositis includes several principles, the main of which is the observance of a correct lifestyle - activity without excessive physical exertion, balanced nutrition and timely treatment of any diseases.
A complete diet helps to avoid inflammation in the muscles - polyunsaturated fatty acids found in fish are useful; foods high in salicylates (vegetables); easily digestible proteins (almonds, chicken); foods containing high amounts of calcium; cereals.
A drinking regimen is very important , in which about two liters of water should be consumed per day. You should not neglect fruit drinks and compotes, green tea is also useful. To eliminate puffiness, it is recommended to take a rosehip decoction. For the prevention of myositis, it is useful to spend time in the fresh air. Many patients are often worried about this question: is it possible to do exercises with ossifying myositis? It is possible, however, the load should be light and metered. In addition to gymnastics, hardening, swimming, cycling are recommended for this disease.
Prevention of myositis also includes constant movement, it is important to prevent physical inactivity and hypothermia. Of course, the absence of any injuries will be the best prevention of pathology.