Article Text

BENIGN ACUTE CHILDHOOD MYOSITIS IN THE EMERGENCY DEPARTMENT
  1. A Z Talento1,
  2. J A Craven1,
  3. C T Martin1
  1. 1Paediatric Emergency Department, Adelaide and Meath National Children’s Hospital, Tallaght, Dublin, Ireland

Abstract

Over a period of 3 months, 16 cases of benign acute childhood myositis were diagnosed in the Paediatric Emergency Department of the National Children’s Hospital.

Objective To present the clinical and laboratory features of the patients diagnosed to have benign acute childhood myositis.

Results Ten males and 6 female patients (3–9 years of age, mean 6 years) presented with lower limb pain and/or refusal to walk. This presentation was preceeded in all cases by a febrile illness with or without upper respiratory tract symptoms for a duration of 2–14 days (mean of 4.6 days). Tender calf muscles were seen in 10 cases and 3 refused to walk. Thirteen of these patients could ambulate, 6 had normal gait, 4 had toe-walking and 3 walked with a stiff wide based gait. Neurologic examination findings were normal in all the patients. Creatinine kinase was elevated in all patients (560–15556 IU/ml). Leukopenia and neutropenia were likewise seen. Two patients were admitted to hospital overnight and 14 were sent home. All sixteen cases recovered within 24–72 hours of presentation.

Conclusion Benign acute childhood myositis is a self limiting syndrome of lower limb pain and difficulty walking with elevated creatinine kinase. It has an excellent prognosis. This diagnosis should be considered when presented with this clinical picture and with careful explanation and out-patient follow-up unnecessary investigations can be avoided and parental anxiety alleviated.

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