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Differential diagnosis of skeletal muscle oedema on MRI

Dr Yuranga Weerakkody et al.

The presence of intramuscular oedema (increased high T2 / STIR signal) on MRI carries an extremely broad differential. They include

trauma
- effects of direct injury / tear
- denervation injury - denervation changes in muscles
early myositis ossficans
inflammatory myopathies
- dermatomyositis
- polymyositis
- inclusion body myositis
- eosinophilic myositis
- proliferative myositis ⁵
- myositis associated with connective tissue diseases
infective myositis
- pyomyositis
- viral myositis
infiltrating neoplasm
acute sub acute phase of auto immune neuropathy
- e.g. Parsonage-Turner syndrome (in the shoulder)
rhabdomyolysis
- drug induced
- intravenous heparin therapy
- trauma
- burns
- toxins
- auto-immune inflammtion
vascular causes
- muscle infarction
  - microvascular disease : e.g. diabetes
- Behcet disease
- sickle cell crisis
overuse
- delayed onset muscle soreness (DOMS)

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