Fascitis

Myositis may also have an infective basis. Viral myositis has been recorded in association with influenza and picomavirus infections, particularly those due to viruses of the Coxsackie group, and HIV infection is an increasingly common cause of myositis seen in routine practice. Fungal, bacterial, and parasitic myositis is seen much more rarely in North America and Europe than in tropical parts of the world, but in these regions these forms of infective myositis constitute a significant problem. In any survey of inflammatory muscle disorders, it is also necessary to consider other inflammatory conditions which affect muscle indirectly, but do not cause myositis in the strict sense of the word. In this group are to be found various forms of arteritis and fascitis and granulomatous conditions such as sarcoidosis. 

Various syndromes associated with hypereosinophilia involve skeletal muscle. There is a rare form of polymyositis which is characterized by this feature (defined as exceeding 1,500 eosinophils/mm for at least six months). Clinical presentation includes skin changes, heart and lung involvement, and peripheral neuropathy as well as proximal myopathy. The condition must be distinguished from trichinosis and other parasitic infections associated with hypereosinophilia. Muscle biopsy findings are interstitial and perivascular infiltrates in which eosinophils predominate but are accompanied by lymphocytes and plasma cells, and occasional muscle fiber necrosis. Fascitis may also be associated with hypereosinophilia (Shulman s syndrome). This condition is characterized by painful swelling of skin and soft tissues of trunk and extremities and weakness of limb muscles. Biopsy of muscle... 

Dermal Effects. Some of the people in Woburn, Massachusetts, who had been chronically exposed to trace amounts of trichloroethylene and other substances in the drinking water reported skin lesions (Byers et al. 1988). These were maculopapular rashes that were said to occur approximately twice yearly and lasted 2-4 weeks. These skin conditions generally ceased 1-2 years after cessation of exposure to contaminated water. The limitations of this study are discussed in Section 2.2.2.8. A case study was published of a 63-year-old rural South Carolina woman exposed to trichloroethylene and other chlorinated hydrocarbons in her well water, who developed diffuse fascitis, although her husband did not (Waller et al. 1994). The level of trichloroethylene measured in the well water was 19 mg/L. Substitution of bottled water for drinking resulted in improved symptoms. 

Diffuse fascitis with eosinophilia was reported in a woman who had used well water contaminated with trichloroethylene (14 mg/L) for 6 years (Waller et al. 1994). 

Waller PA, Clauw D, Cupps T, et al. 1994. Fascitis (not scleroderma) following prolonged exposure to an organic-solvent (trichloroethylene). J Rheumatol 21 1567-1570. 

Plantar fascitis is an inflammation of the plantar fascia of the foot, usually at its insertion on the calcaneus. When chronic in nature, a calcification may develop at the site of insertion of the tendon and a diagnosis of a heel spur is made. 

Internal derangement of the knee Patellar bursitis Tarsal tunnel syndrome Plantar fascitis. 

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