PMC9585659_01
Side view of the patient before glucocorticoid decrement (A) and 1 year after glucocorticoid decrement (B). Arrows indicate sites with apparent muscle atrophy.
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Physical examination revealed moon face, violaceous striae on the skin of proximal limbs and abdomen, and muscular dystrophy of both legs ( Figure 1A ). During a 1 year of follow-up, her muscle strength recovered and muscular dystrophy also improved ( Figure 1B ).
Radiological and histological findings of the case. MRI scan showed abnormal signals in bilateral femoral head (A), distal femur and upper tibia (B), suggesting ischemic necrosis or infarction. Arrows indicate the lesions. H&E staining of the biopsy showed scattered myofiber atrophy (C). ATPase staining revealed atrophy of type II myofibers (D). Arrow heads indicate the lesions.
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MRI revealed osteonecrosis in the femoral head, distal femur, and proximal tibia of both legs ( Figures 2A, B ). Histological examinations revealed atrophy of type II myofiber without significant leukocyte infiltration, which were suggestive of steroid myopathy ( Figures 2C, D ).