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2017 ; 63
(5
): 365-368
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Viral myositis in children
#MMPMID28500193
Magee H
; Goldman RD
Can Fam Physician
2017[May]; 63
(5
): 365-368
PMID28500193
show ga
Question I recently evaluated a child in my clinic after an emergency department
visit where she presented having woken up that morning refusing to walk and was
crawling around the house. The parents reported she was getting over a cold, and
I recall similar cases of myositis during the H1N1 influenza epidemic a few years
ago. What are the key features of myositis that I should recognize? Which
investigations are needed to confirm the diagnosis and how should affected
patients be managed? Answer Benign acute childhood myositis is a mild and
self-limited sudden onset of lower extremity pain during or following recovery
from a viral illness. Presentation can include tiptoe gait or refusal to walk,
secondary to symmetric bilateral lower extremity pain that resolves quickly,
usually within 3 days. In general, no investigation is needed except in severe
cases for which screening bloodwork and a urine myoglobin test can confirm the
diagnosis and rule out complications. Myoglobinuria and highly elevated creatine
phosphokinase levels are rare but should be a consideration for admission to
hospital. Prognosis is excellent and management might include rest and analgesia.
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