Work

A rare case of focal myositis affecting the sternocleidomastoid muscle: diagnostic challenges and management strategies.

Year: 2025

Type: article

Abstract: Introduction: Focal myositis is a rare inflammatory disease characterised by localised involvement of a single muscle or muscle group. Involvement of the sternocleidomastoid muscle represents an extremely rare localisation. Materials and methods: We report the case of a 78-year-old woman who developed progressive left laterocervical swelling and pain following a respiratory infection. Extensive clinical and radiological investigations were performed; however, a definitive diagnosis was achieved only after muscle biopsy. Results: The patient initially responded to corticosteroid therapy but subsequently developed steroid dependence. For long-term disease control, methotrexate was introduced as a steroid-sparing agent. The clinical course was notable for recurrent disease exacerbations associated with fever. Discussion: This case presents several distinctive features, including occurrence in an elderly patient, the presence of fever during disease flares, and a steroid-dependent course requiring second-line immunosuppressive therapy. These aspects contribute to the diagnostic and therapeutic complexity of focal myositis, particularly in atypical localisations. Conclusion: Our experience highlights the diagnostic challenges associated with this rare entity and suggests that prolonged immunosuppressive treatment may be necessary in selected patients with focal myositis.

Source: Acta myologica : myopathies and cardiomyopathies : official journal of the Mediterranean Society of Myology / edited by the Gaetano Conte Academy for the study of striated muscle diseases

DOI: 10.36185/2532-1900-1552

Authors: Nicola Molitierno, Mosè Parisi, Delia Gagliardi, Stefania Corti, Daniele Velardo

Institutions: University of Milan, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico

Language: English

Topic: Inflammatory Myopathies and Dermatomyositis

Subfield: Epidemiology

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: diamond

Funder: European Commission