CTICasesMyositis
Imaging findings
Chest CT in a young woman with a history of myasthenia gravis shows marked, symmetric, and diffuse fatty atrophy of the pectoralis, deltoid, and paraspinal muscles. The lung windows show a nonspecific interstitial pneumonia (NSIP) pattern, and the esophagus is dilated. Anti-RNP and anti-Smith antibodies are positive.
Key takeaways
Polymyositis or mixed connective tissue disease (MCTD) can present with profound, symmetric skeletal muscle atrophy and fatty infiltration, which can coexist with other autoimmune conditions like myasthenia gravis. The presence of secondary thoracic findings, such as an NSIP pattern (peripheral ground-glass and reticulation) and esophageal dilation, are key clues pointing to mixed connective tissue disease/Myositis rather than isolated myasthenia.
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