Reason: patient with dermatomyositis with increased weakness of shoulders now with high CK and aldolase History: patient with dermatomyositis with increased weakness of shoulders now with high CK and aldolase Left humerus:There is patchy irregular increased signal abnormality on fluid sensitive sequences as well as enhancement of the lateral aspect of the brachialis muscle belly just proximal to the level of the myotendinous junction at the level of the mid to distal humeral diaphysis (image 7; series 12). Otherwise no abnormal enhancement or mass lesions are identified. The imaged musculature of the left arm is otherwise unremarkable. There is an enchondroma within the humeral head. Otherwise no bone marrow signal abnormality is identified. Although this examination was not protocoled for detailed evaluation of the shoulder, the glenohumeral joint alignment is anatomic and no large effusion is evident.Right humerus:There is also patchy irregular increased signal abnormality on fluid sensitive sequences as well as enhancement along the lateral aspect of the brachialis muscle belly on the right, to a lesser degree than the left, at the level of the myotendinous junction at the level of the distal humeral diaphysis (image 19; series 3). The remainder of the musculature is unremarkable. No bone marrow signal abnormality is identified. Although this examination was not protocoled for detailed evaluation of the shoulder, no large effusion is evident. The glenohumeral joint alignment is anatomic. No additional pathologic enhancement or focal mass lesions are identified
Nonspecific enhancing signal abnormality of the brachialis muscles, left greater than right, which could represent a myositis in the correct clinical setting.