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Thirty-eight children (32 boys, 6 girls) were seen with 41 episodes of myositis between 1978 and 1997. Two were siblings and three had recurrent episodes. Mean age onset of symptoms was 8.1 years. Children remained ambulant during 33 of 4 1 episodes. Two characteristic gaits were noted: toe-walking in 13, with a wide-based stiff-gait in another 7. Muscle tenderness was isolated to the gastrocnemius-soleus muscles in 82% of episodes. Recovery occurred within 1 week. Creatine kinase leve ls were elevated during all episodes. Viral studies were positive in 10 of 24 episodes, 5 because of influenza B. Benign acute myositis is a syndrome of midchildhood that can be differentiated from more serious causes of walking difficulty by the presen ce of calf tenderness, normal power, intact tendon reflexes, and elevated creatine kinase. The gait patterns noted may minimize power generation of the calf muscles by splinting the ankles. Onset in childhood may reflect an age-related response to viral infection, and occurrence primarily in boys may reflect a genetic predisposition or an as-yet unknown metabolic defect. |
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children
cough
creatine phosphokinase(CPK)elevated
fever
influenza A virus
influenza B virus
muscle pain
muscle tenderness
myositis
myositis,acute of childhood
myositis,post infectious
pain,calf
prognosis
tenderness
toe walking
viral infection
viral myopathy
walking,difficulty with
wide based gait
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