PMC5615159_01
Incisional biopsy from skeletal muscle of the buttock. (A) Low magnification showing necrosis (*) of some skeletal muscle cells. (B) Higher magnification showing necrotic cells (*) scattered among normal-appearing skeletal muscle cells. Inflammatory infiltrate and fibrosis are lacking.
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Gluteus muscle biopsies revealed lytic necrosis of the myocytes at different stages, and significant macrophage infiltration with limited presence of TCD4+ cells (Fig. 1).
Muscle oedema on fluid-sensitive MRI sequences. Axial T2-weighted (a) and fat-suppressed T2-weighted (b) MR images show diffuse increased signal intensity of the left gluteus maximum muscle (white arrows). Axial T2-weighted (c) and fat-suppressed T2-weighted (d) MR images show atrophy and increased signal intensity of the right and left semitendinosus muscles (white arrows).
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Muscle bilateral thighs Magnetic Resonance (Fig. 2) found widespread hyperintensity and oedema of gluteus muscle.