Service de Rhumatologie, Centre Hospitalier de Cahors, Cahors, France.
Semin Arthritis Rheum. 2011 Dec;41(3):477-81. doi: 10.1016/j.semarthrit.2011.02.004. Epub 2011 May 18.
Involvement of the gluteus medius muscle has been reported in girdle myopathies or facioscapulohumeral myopathies. Camptocormia, or Bent spine syndrome, characterized by involuntary forward flexion of the trunk in the standing position, may be secondary to a late-onset myopathy essentially involving the spinal erector muscles. In this article, we report the observations of patients with severe deficiency of the gluteus medius, suggesting a late-onset myopathy.
Computed tomography and magnetic resonance imaging (MRI) were performed in 17 patients, with a mean age 76 years, 3 men and 14 women, presenting a Trendelenburg limp related to fatty infiltration of the gluteus medius muscles. Eight of these patients also had camptocormia.
Computed tomographic scan and MRI appearance differed from that of age-matched controls and suggested myopathy. MRI excluded an inflammatory disorder or disinsertion of the gluteus medius muscle. Biopsies of gluteus medius and paravertebral muscles showed marked septal fibrosis and adiposis, whereas control biopsies were normal. Creatine phosphokinase was moderately increased in two thirds of patients.
Involvement of the gluteus medius muscles, like involvement of the paravertebral muscles with which it is frequently associated, may be a form of late-onset girdle myopathy.
臀中肌参与带肌病或面肩肱型肌营养不良症的报道。脊柱前凸，或弯曲脊柱综合征，其特征是在站立位时躯干不自主向前弯曲，可能继发于主要累及脊柱伸肌的迟发性肌病。本文报告了 17 例臀中肌严重缺陷患者的观察结果，提示存在迟发性肌病。
对 17 例患者进行了计算机断层扫描和磁共振成像（MRI）检查，平均年龄为 76 岁，3 名男性和 14 名女性，表现为与臀中肌脂肪浸润相关的特伦德伦堡跛行。其中 8 例患者还存在脊柱前凸。
CT 扫描和 MRI 表现与年龄匹配的对照组不同，提示存在肌病。MRI 排除了炎症性疾病或臀中肌的离断。臀中肌和椎旁肌肉活检显示明显的间隔纤维化和脂肪增多，而对照组活检正常。肌酸磷酸激酶在三分之二的患者中中度升高。
臀中肌的受累，就像其经常相关的椎旁肌肉受累一样，可能是一种迟发性带肌病。
