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Calf muscle pain can indicate localised vasculitis

Patients with unexplained calf muscle pain may have a rare form of vasculitis, distinct from localised polyarteritis nodosa (PAN), French doctors have discovered. They should have an MRI examination without delay as the findings are diagnostic. Corticosteroid (CS) treatment is recommended, with supplementary immunosuppressive treatments for relapses.

The advice is based on the first retrospective series of 11 biopsy proven cases of vasculitis of the leg compared with published findings. On MRI examination an intense T2-weighted signal over the affected area and intense T1-weighted signal with gadolinium injection is characteristic of the condition. Biopsy specimens from the highlighted area of muscle showed leucocytoclastic vasculitis in seven cases; in the four other cases the appearance was consistent with PAN, as in the all of the published cases.

Taken together, this case series and previous reports indicate that CS treatment seems effective, but the course of the disease is not as benign . . . [Full text of this article]