Hi there,
this is a 40 year old female with marked edema of both forearms for a week. No pain or fever. No statins or similar.
Marked CK elevation. Liver cirrhosis Child A, auto-immune cholangitis. Thoracic outlet syndrome or subclavian thrombosis not ruled out yet. I’m explicitely mentioning that because, were it not for the elevated CK, I would have thought this is lymphatic or venous edema, because of the massive subq edema. Also in this case it’s the forearms not the thighs or something more typical. On the other hand the diffuse yet patchy contrast uptake in the muscles could well fit myositis.
What is your impression?
Cheers,
Andrei
