CTICasesPolymyositis Presenting as Organizing Pneumonia
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Imaging findings
A patient presenting with acute shortness of breath after lifting weights shows peribronchial consolidation and peripheral opacities on CT, characteristic of organizing pneumonia. Further examination reveals very small muscles with symmetric fatty atrophy of many proximal muscles, uncharacteristic for a 50-year-old male involved in weight training.
Key takeaways
Organizing pneumonia can be the initial presentation of a collagen vascular disease. The unexplained severe muscle wasting and fatty atrophy, combined with a highly elevated CK level (e.g., 2,000), strongly suggest polymyositis as the underlying condition, even in the absence of a rash.
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