Miozit – group of the diseases which are followed by development of inflammatory process in skeletal muscles. The reason, localization, symptomatology, the nature of defeat and a current of miozit can significantly differ. The most characteristic general symptom is the local affected muscle pain (or muscles) amplifying at the movements and a palpation. Over time owing to the protective tension of muscles there can be a restriction of volume of movements in joints. At a long current of some miozit increase of muscular weakness, and sometimes – even an atrophy of the affected muscle is noted. System diseases, sharp or chronic infections, injuries, parasites, overcooling, excessive tension of muscles, etc. can become the reason of development of a miozit. The scheme of treatment of a miozit is selected individually and depends on a form of a disease and the reason which caused it.
Miozit – inflammatory process in one or several skeletal muscles. The etiology of a disease differs in rare variety. Most often various infections (a SARS, flu, chronic tonsillitis) become the reason of development of a miozit. Besides, miozit can arise at autoimmune diseases, owing to parasitic infections, influence of toxic substances etc. The disease can proceed both sharply, and chronically. In certain cases skin is involved in process. Under certain conditions (local infection) development of purulent process in a muscle is possible.
Weight of a miozit can strongly vary. The most widespread miozita – cervical and lumbar – at least once develop in lives almost at all people. Often they remain not diagnosed as patients take manifestations of a miozit for an exacerbation of cervical or lumbar osteochondrosis. But also the severe forms of a miozit demanding hospitalization and long-term treatment meet.
Taking into account the nature of process allocate sharp, subsharp and chronic miozita, taking into account prevalence – local (limited) and diffusion (generalized). Besides, distinguish several special forms of a miozit:
- Infectious not purulent miozit. Arises at viral infections (enteroviral diseases, flu), syphilis, a bruzzeleza and tuberculosis. Is followed by severe pain in muscles and noticeable general weakness.
- Sharp purulent miozit. Usually is manifestation of a septikopiyemiya or a complication of chronic purulent process (for example, osteomyelitis), it is characterized by existence of purulent and necrotic processes in muscles. Is followed by local hypostasis and the expressed local pain. Temperature increase of a body, a fever and is possible.
- Miozit at parasitic infections. Arises owing to toksiko-allergic reaction. Is followed by pain, hypostasis and tension of muscles. The indisposition, small temperature increase, is possible. Quite often has the wavy current caused by a cycle of activity of parasites.
- Ossfitsiruyushchy miozit. As a rule, arises after injuries, but maybe congenital. Distinctive feature is adjournment of salts of calcium in connecting fabric. Most often shoulders, hips and buttocks are surprised. Is followed by weakness of muscles, the progressing muscular atrophy, consolidation of muscles and formation of kaltsinat. Pains are usually unsharp.
- Polimiozit. Multiple damage of muscles. Polimiozit usually develops at system autoimmune diseases, is one of the most severe forms of a miozit. Is followed by pain and the increasing muscular weakness. In some cases at such miozita the atrophy of muscles and disappearance of tendinous reflexes is possible. At children it can be combined with damage of lungs, hearts, vessels and skin. At men 40 years in half of cases are aged more senior simultaneous formation of tumors of internals is noted.
- Dermatomiozit (a disease of Vagnera-Unferrikhta-Heppa, Wagner's disease). Dermatomiozit is a system disease, is followed by damage of skin, skeletal and smooth muscles, and also internals.
First place on the frequency of incidence is won by the miozita caused by the most widespread viral infectious diseases (a SARS, flu). Miozit arises at bacterial and fungal infections less often. Perhaps as direct impact of microorganisms on muscles, so development of a miozit owing to effect of toxins.
System autoimmune diseases are not the most frequent reason of miozit, but they cause development of the most severe forms of a disease. As a rule, the most severe damage of muscles arises at a polimiozita, a dermatomiozita and Myunkheymer's disease (an ossifitsiruyushchy miozit). Moderately expressed miozita are characteristic of other system diseases (rheumatoid arthritis, a sklerodermiya, a system red volchanka). Among parasitic infections, miozit the most often defiant – toxoplasmosis, echinococcosis, cysticercosis and trichinosis.
Effect of various toxic substances, both constant, and rather short-term can become the reason of development of a miozit. So, toxic miozit quite often develops at alcoholism or cocaine addiction. Unstable damages of muscles can arise also at reception of some medicines (alpha interferon, hydroxychlorocinchona, colchicine, statin etc.). Such defeats not always have inflammatory character therefore, depending on symptoms, they can be carried both to miozita, and to myopathies.
Favorably proceeding miozita easy, are more rare – moderate severity can arise after overcooling, injuries, muscular spasms or intensive physical activities (especially – at patients with unexercised muscles). Pain, hypostasis and weakness within several hours or several days in the latter case is caused by small anguishes of muscular tissue. In extremely exceptional cases, usually at extreme physical activities development of a rabdomioz – a necrosis of muscular tissue is possible. Rabdomioz can also arise at polimiozita and dermatomiozita.
At people of certain professions (violinists, pianists, keyboarders, drivers, etc.) miozit can develop owing to an uncomfortable position of a body and long load of certain groups of muscles. The open trauma with an infection drift, the center of a chronic infection in an organism or local infection owing to violation of the rules of hygiene when carrying out intramuscular injections can become the cause of a purulent miozit.
Most often local miozit (defeat of one or several, but not sets of muscles) develops in muscles of a neck, a waist, a thorax and shins. A characteristic symptom of a miozit is the aching pain amplifying at the movement and a palpation of muscles and which is followed by muscular weakness. In some cases at a miozita insignificant reddening (hyperaemia) of skin and small puffiness in the field of defeat is observed. Sometimes miozita are followed by the general manifestations: subfebrilny temperature or fever, a headache and increase in quantity of leukocytes in blood. At a palpation of the affected muscle painful consolidations can be defined.
Miozit can sharply develop or have initially chronic current. The sharp form can also pass into chronic. Usually it occurs for lack of treatment or at inadequate treatment. Sharp miozita arise after a muscular overstrain, a trauma or overcooling. The gradual beginning with less pronounced clinical symptoms and initially chronic current is characteristic of infectious and toxic miozit.
Chronic miozit proceeds wavy. Pains appear or amplify at long static loadings, change of weather, overcooling or an overstrain. Weakness of muscles is noted. Restriction of movements (usually insignificant) in nearby joints is possible.
treatment should be carried out only under the supervision of a doctor. Self-treatment is unacceptable!!!
Doctors of various profile are engaged in treatment of a miozit, the choice of the expert is defined by a cause of illness. So, miozita of a parasitic etiology parasitologists, infectious miozita – therapists or infectiologists, the traumatic miozita and miozita which developed after considerable physical activity – traumatologists etc. usually treat. Therapy of miozit includes pathogenetic and symptomatic actions. At bacterial damage antibiotics are appointed, at parasitic – antigelmintny means. At the miozita which are a consequence of an autoimmune disease long courses of immunosupressor and glucocorticoids are shown.
At sharp miozita and an aggravation of chronic miozit recommend to the patient a bed rest and restriction of physical activity. At temperature increase appoint febrifuges. To fight against a pain syndrome apply analgetics, to elimination of an inflammation – anti-inflammatory medicines, usually from the NPVS group (ketoprofen, an ibuprofen, diclofenac etc.). At local miozita the warming ointments are effective. Local irritant action of these medicines promotes relaxation of muscles and allows to reduce intensity of a pain syndrome. Also massage (it is contraindicated at a purulent miozit), physiotherapeutic procedures and physiotherapy exercises is applied. At purulent miozita opening and drainage of the purulent center is carried out, antibiotics are appointed.
Cervical and lumbar miozit
Cervical miozit – the most widespread of all miozit. Usually develops as a result of cold, after an overstrain of muscles or long stay in an inconvenient pose. Is followed by dull ache which is more often localized only on the one hand necks. Sometimes pain gives to a nape, to a temple, an ear, a shoulder or interscapular area. At the movements of the patient miozity spares a neck, the movements in cervical department of a backbone can be a little limited because of pain.
Lumbar miozit is also rather widespread. Because of identical localization of pain patients sometimes confuse it with , however, pain in this case not such sharp, mainly aching character, does not decrease at rest, amplifies at the movements and pressing on muscles of the struck area.
Cervical miozit and miozit lumbar muscles usually it is necessary to differentiate with an exacerbation of osteochondrosis, and lumbar miozit – also with hernia of the relevant department of a backbone. At diagnosis pay attention to the nature of pain (aching), strengthening of morbidity at a palpation of muscles and existence or lack of neurologic symptomatology. For specification of the diagnosis the X-ray analysis of a backbone, neck MRT, a magnetic and resonant tomography of a backbone or a computer tomography can be executed.
It is necessary to consider that sometimes the constant, not too intensive aching pain in lumbar area testifies to a disease of kidneys. Therefore when developing such pains it is necessary to see surely a doctor that he estimated clinical symptomatology, confirmed or excluded the diagnosis miozit and if necessary directed the patient to additional researches (blood test and urine, ultrasonography of kidneys, etc.).
Dermatomiozita and polimiozita
Dermatomiozit treats group of system diseases of connecting fabric. Meets rather seldom – according to foreign researchers five people on 1 million population are ill. Usually strikes children aged up to 15 years or people of mature age (50 years and are more senior). At women it is observed twice more often than at men.
Typical symptoms from skin and muscles are considered as classical manifestations of such miozit. Weakness of muscles of a pelvic and humeral belt, muscles of an abdominal tension and a sgibately neck is observed. Patients experience difficulties at a rising from a low chair, rise on a ladder, etc. When progressing a dermatomiozit it becomes difficult for patient to hold the head. In hard cases damage of glotatelny and respiratory muscles with development of respiratory insufficiency, difficulty of swallowing and change of a timbre of a voice is possible. The pain syndrome at a dermatomiozita is expressed not always. Reduction of muscle bulk is noted. Over time sites of muscles are replaced with connecting fabric, tendinous and muscular contractures develop.
From skin are observed geliotropny rash (red or lilac rashes on centuries, sometimes – on a face, a neck and a trunk) and Gottron's symptom (the pink or red shelled plaques and small knots on the razgibatelny surface of small and average joints of extremities). Perhaps also damage of lungs, hearts, joints, digestive tract and violation from endocrine system. Approximately a quarter of patients has manifestations only from muscles. In this case the disease carries the name polimiozit.
The diagnosis is exposed on the basis of a clinical picture and these biochemical and immunological blood tests. For confirmation of the diagnosis the biopsy of muscles can be carried out. The basis of therapy is made by glucocorticoids. According to indications cytostatic medicines (, , a methotrexate), and also the medicines allocated for maintenance of functions of internals, elimination of metabolic disorders, improvement of microcirculation and prevention of development of complications are applied.
Is not one disease, but group of diseases of connecting fabric. It is characterized by formation of sites of ossification in muscles. Can arise owing to a trauma or to be congenital, genetically caused. Traumatic ossifitsiruyushchiya miozit differs in rather favorable current. Only muscles and articulate ligaments in the field of a trauma are surprised. It is treated surgically. The end result of operation depends on localization and prevalence of damage.
Progressing ossifitsiruyushchiya miozit is a hereditary disease. Begins spontaneously, gradually covers all groups of muscles. The current of a miozit differs in unpredictability. Specific prevention and treatment does not exist yet. Death at the progressing miozit comes owing to ossification of glotatelny and pectoral muscles. Meets extremely seldom – 1 diseased on 2 million people.