Reason: patient with sub-acute weakness, and muscle wasting, elevated CK, CRP c/f myositis. Obtaining MR to look for myositis. History: above Left femur:On the fat-saturated T2-weighted images, there is edema type signal abnormality within the adductor musculature of the left hip and thigh as well as within the hamstrings, with relative sparing of the semitendinosus muscle. There is perhaps also mild edema within the rectus femoris and vastus medialis, proximally, but we see no additional edema within the quadriceps musculature. Overall the muscles appear slightly atrophic, which is not unusual considering the patient's age. Severe osteoarthritis affects the left knee. Moderate osteoarthritis affects the left hip. There is patchy intermediate signal intensity within the proximal femur likely representing residual islands of red marrow. There is a small to moderate knee joint effusion.Right femur:On the fat saturated T2-weighted images there is edema of the adductor musculature of the right hip and thigh as well as within the hamstring musculature, with relative sparing of the semitendinosus muscle. There is mild edema of the vastus medialis, proximally. The remainder of the quadriceps appears spared. The sartorius appears spared. Severe osteoarthritis affects the right knee. There is a moderate sized right knee joint effusion. There is fatty atrophy of the musculature of the hip and thigh which is not unusual considering the patient's age. There is prominence of fat along the anterolateral aspect of the distal femur deep to the lateral retinaculum, representing a lipoma.
Largely symmetric myositis pattern of the hip and thigh musculature as described above.