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Postgrad Med J 89:59 doi:10.1136/postgradmedj-2012-130974
  • Images in medicine

Orbital myositis as manifestation of Systemic Lupus Erythematosus - a case report

  1. Sheila Vasoo
  1. Division of Rheumatology, Department of Medicine, NUHS, Singapore, Singapore
  1. Correspondence to Dr Sheila Vasoo, Division of Rheumatology, Department of Medicine, NUHS, Tower Block Level 10, 1E Kent Ridge Road, Singapore 119228, Singapore; sheila_vasoo{at}nuhs.edu.sg

A 38-year-old woman with Systemic Lupus Erythematosus (SLE) was admitted with sudden onset of painful proptosis of her left eye (figure 1A). Examination revealed a markedly proptosed left eye with chemosis, ptosis and painful reduction of eye movements. Visual acuity was preserved. Apart from coryzal symptoms, there were no other systemic features of infection. A CT scan of the orbits revealed diffuse thickening of the left lateral rectus muscle (Solid arrows) with retro-orbital fat stranding (Broken arrow), compatible with focal myositis (figure 1B,C). There was no other intracranial space occupying lesion. Her creatine kinase levels and thyroid function were normal, anti-neutrophil cytoplasmic antibody was negative but erythrocyte …