|
|
(34 intermediate revisions by 2 users not shown) |
Line 1: |
Line 1: |
− | {{review}}
| + | #redirect[[:Category:Muscles - Inflammatory Pathology]] |
− | | |
− | {{toplink
| |
− | |backcolour =CDE472
| |
− | |linkpage =Musculoskeletal System - Pathology
| |
− | |linktext =Musculoskeletal System
| |
− | |maplink = Musculoskeletal System (Content Map) - Pathology
| |
− | |pagetype =Pathology
| |
− | |sublink1=Muscles - Pathology
| |
− | |subtext1=MUSCLES
| |
− | }}
| |
− | <br>
| |
− | ==Myositis==
| |
− | | |
− | *Inflammation of muscle
| |
− | | |
− | | |
− | ===Bacterial myositis===
| |
− | | |
− | *Bacteria gain entry via:
| |
− | **Direct penetration
| |
− | **Blood stream
| |
− | **Extension
| |
− | *Lesions caused:
| |
− | **Suppurative
| |
− | **Serosanguinous
| |
− | **Granulomatous
| |
− | | |
− | | |
− | ====Abscesses====
| |
− | | |
− | *Caused by pyogenic bacteria
| |
− | *Usually:
| |
− | **[[Arcanobacter pyogenes|''Arcanobacterium pyogenes'']] in sheep and cattle
| |
− | **[[Respiratory Bacterial Infections - Pathology#Strangles|''Streptococcus equi'']] in horses
| |
− | **''[[Corynebacterium pseudotuberculosis]]'' in sheep and goats
| |
− | **[[Pasteurella multocida|''Pasteurella multocida'']] causes cellulitis in cats
| |
− | *Usually localised suppuration and necrosis of myofibres
| |
− | *Occasionally my spread via the fascia
| |
− | | |
− | | |
− | ====Black leg====
| |
− | [[Image:Black leg myositis.jpg|right|thumb|100px|<small><center>Blackleg myositis (Image sourced from Bristol Biomed Image Archive with permission)</center></small>]]
| |
− | | |
− | *Causative agent: ''[[Clostridium chauvoei]]''
| |
− | *May affect the fattest cattle at pasture in the summer
| |
− | *Rapid toxaemia -> death
| |
− | *If clinical signs observed:
| |
− | **Toxaemia -> pyrexia, depression, [[Lungs Circulatory - Pathology#Pulmonary oedema|pulmonary oedema]], circulatory collapse
| |
− | **Muscle lesions -> lameness, swollen hot muscles later becoming cool as necrosis sets in
| |
− | *Pathogenesis:
| |
− | **Spores gain entry to GI tract -> blood -> muscle -> lie latent
| |
− | **Under right conditions (usually anaerobic following injury) they germinate and bacilli grow
| |
− | **Toxin damages capillaries -> serosanguinous exudate
| |
− | **Muscle necrosis due to gas producing bacteria -> emphysaema and crepitus
| |
− | *Grossly:
| |
− | **Early stages
| |
− | ***At muscle periphery
| |
− | ***Dark red
| |
− | ***Distended by serous or serosanguinous exudate
| |
− | ***Wet cut surface
| |
− | **Old stages
| |
− | ***Centre of lesion is full of gas bubbles, porous, dry, reddish black
| |
− | ***Rancid odour
| |
− | *Histologically:
| |
− | **Early stages
| |
− | ***Separation of myofibres by exudate
| |
− | ***[[Necrosis - Pathology#Coagulation Necrosis|Coagulative necrosis]]
| |
− | ***No nuclei
| |
− | **Old stage
| |
− | ***Fragmented muscle fibres separated by gas bubbles
| |
− | ***Gram positive bacilli may be found in clumps
| |
− | | |
− | ====[[Necrosis - Pathology#Gas Gangrene|Gas gangrene]]====
| |
− | | |
− | *Causative agents: [[:Category:Clostridium species|''Clostridium septicum, C. novyi, C. perfringens, C. sordelli'']]
| |
− | *Normally in soil
| |
− | *Bacteria gain entry as spores via penetrating wounds
| |
− | *Serohaemorrhagic myositis
| |
− | *If only subcutis and fascia are involved - '''malignant oedema'''
| |
− | *Toxaemia and septicaemia -> rapid death
| |
− | | |
− | | |
− | ====[[Actinobacillosis|Wooden tongue]]====
| |
− | | |
− | *Also called '''Actinobacillosis'''
| |
− | *Caused by ''[[Actinobacillus lignieresii]]''
| |
− | *Usually due to direct penetration into tongue of cattle
| |
− | *Small granulomatous lesions containing 'sulfa granules' of large numbers of gram-negative rods
| |
− | | |
− | ====Tuberculosis====
| |
− | | |
− | *Caused by ''[[Mycobacterium bovis]]''
| |
− | *Grossly:
| |
− | **Yellowish spherical nodules
| |
− | **[[Necrosis - Pathology#Caseation Necrosis|Caseous content]]
| |
− | **Fibrous capsule usually
| |
− | *Histologically:
| |
− | **Granuloma
| |
− | **Central necrosis
| |
− | **Epitheliod and giant cells at periphery
| |
− | | |
− | | |
− | ====''[[Actinomyces bovis]]''====
| |
− | *"Lumpy jaw"
| |
− | *May extend to muscles, especially masseters, from [[Bones Inflammatory - Pathology#Osteomyelitis|osteomyelitis]]
| |
− | *Histologically:
| |
− | **Caseous or suppurative centres of lesions
| |
− | **Epithelioid and giant cells at periphery
| |
− | **'Sulfa granules' at centre - gram-positive branching rods
| |
− | | |
− | ====[[Botryomycosis]]====
| |
− | | |
− | | |
− | | |
− | | |
− | ===Viral myositis===
| |
− | | |
− | *Rare in the UK
| |
− | | |
− | ====[[Porcine encephalomyelitis]]====
| |
− | | |
− | ====Foot and Mouth disease====
| |
− | | |
− | *Caused by [[Picornaviridae|Apthovirus]]
| |
− | *Main presentation are vesicles
| |
− | *May also involve skeletal and heart muscle
| |
− | *Grossly:
| |
− | **Yellow streaks and grey foci
| |
− | *Histologically:
| |
− | **Segmental myofibre [[Muscles Degenerative - Pathology#Necrosis|necrosis]]
| |
− | **Infiltration of lymphocytes and [[Neutrophils - WikiBlood|neutrophils]]
| |
− | | |
− | | |
− | ====[[Bluetongue Virus|Bluetongue]]====
| |
− | | |
− | *Caused by [[Reoviridae|bluetongue virus of family Reoviridae]]
| |
− | *Non-contagious
| |
− | *Insect-borne
| |
− | *Causes vasculitis, especially in oral cavity
| |
− | *Grossly:
| |
− | **Infarctions -> necrosis
| |
− | **Haemorrhage
| |
− | *Histologically:
| |
− | **Necrosis -> calcification or regeneration (depends on age of lesion)
| |
− | | |
− | | |
− | ===Parasitic myositis===
| |
− | [[Image:taenia ovis cysticerci.jpg|right|thumb|100px|<small><center>''T. ovis'' cysticerci (Image sourced from Bristol Biomed Image Archive with permission)</center></small>]]
| |
− | [[Image:Sarcocyst in muscle.jpg|right|thumb|100px|<small><center>Sarcocyst (Image sourced from Bristol Biomed Image Archive with permission)</center></small>]]
| |
− | *Rare in domestic animals
| |
− | | |
− | | |
− | ====Nematodes====
| |
− | | |
− | *[[Trichinelloidea|'''''Trichinella''''']] larvae
| |
− | **Particularly in pigs and dogs
| |
− | **Public health and economic importance
| |
− | **''T. spiralis'' affecting dogs, pigs, cats and humans is most common in hotter climates
| |
− | **Larvae distend myofibres
| |
− | **May be seen grossly if dead and calcified
| |
− | **Predilection for active muscles, ''e.g.'' diaphragm, intercostal, masseter and tongue muscles
| |
− | **Histologically:
| |
− | ***Focal myositis - [[Neutrophils - WikiBlood|neutrophils]], lymphocytes, eosinophils
| |
− | | |
− | *[[Ancylostomatoidea|''Ancylostoma'']] larvae
| |
− | **Cause inflammation and [[Muscles Degenerative - Pathology#Necrosis|necrosis]]
| |
− | *[[Ascaridoidea|Ascarid]] larvae
| |
− | *[[Dirofilaria immitis|''Dirofilaria immitis'']] in dogs causing ischaemic myopathy due to [[Muscles Degenerative - Pathology#Ischaemia|infartcs]]
| |
− | | |
− | | |
− | ====Cestodes====
| |
− | | |
− | *[[Taenia|''Taenia solium, '']] - cysticercosis in swine and humans
| |
− | *[[Taenia|''T. ovis'']] - cysticercosis in sheep
| |
− | *[[Taenia|''T. saginata'']] in cattle cysticercosis
| |
− | *[[Taenia|''Multiceps serialis'']] in rabbits, primates coenurosis
| |
− | *[[Echinococcus|''Echinococcus granulosus'']] hydatid disease in herbivores and humans
| |
− | | |
− | ====Protozoa====
| |
− | | |
− | *[[Toxoplasma|'''''Toxoplasma gondii''''']]
| |
− | **Cats as final hosts
| |
− | **Intermediate hosts, birds and mammals have tachyzoites throughout body, infrequently in skeletal muscle
| |
− | **Histologically:
| |
− | ***Multifocal [[Muscles Degenerative - Pathology#Necrosis|necrosis]] of myofibres
| |
− | ***Lymphocyte and plasma cell infiltration
| |
− | ***In later stages bradyzoite cysts
| |
− | *[[Neospora|'''''Neospora caninum''''']]
| |
− | **Necrotising inflammation of muscles
| |
− | **Myositis more severe than in toxoplasmosis
| |
− | *[[Sarcocystis|'''''Sarcocystis''''']]
| |
− | **Histologically:
| |
− | ***Merozoites causing focal and segmental [[Muscles Degenerative - Pathology#Necrosis|necrosis]]
| |
− | ***May involve [[Muscles Degenerative - Pathology#Calcification|mineralisation]]
| |
− | ***Non-purulent myositis with plasma cells, lymphocytes and macrophages
| |
− | **Diaphragm and masseters most severely affected
| |
− | *[[Bones Hyperplastic and Neoplastic - Pathology#Hepatozoon|'''''Hepatozoon americanum''''']]
| |
− | **Develop cysts in skeletal muscle of dogs and cats
| |
− | **May be accompanied by pyogranulomatous myositis - macrophages and [[Neutrophils - WikiBlood|neutrophils]] mainly with occasional other cells
| |
− | *'''''Trypanosoma'''''
| |
− | **Infrequent muscle lesions with mononuclear infiltrates
| |
− | **Dogs, cats and pigs are affected
| |
− | **Parasites lie between myofilaments
| |
− | **May cause fibre degeneration
| |
− | *'''''Babesia bovis'''''
| |
− | **In cattle
| |
− | **Infrequent muscle [[Muscles Degenerative - Pathology#Necrosis|necrosis]]
| |
− | | |
− | | |
− | ====Arthropods====
| |
− | | |
− | *Dipterious larvae causing myiasis
| |
− | *[[Insecta|''Hypoderma'' spp.]] in cattle
| |
− | **May occasionally burrow into muscle
| |
− | | |
− | | |
− | ===Immune-mediated myositis===
| |
− | | |
− | ====Masticatory muscle myositis (MMM)====
| |
− | | |
− | *Occurs in dogs
| |
− | *Tends to affect the masseter and temporalis muscles
| |
− | *Autoantibodies selectively attack muscles of mastication (type IIM fibres)
| |
− | *Acute stage = eosinophilic myositis
| |
− | **Extremely swollen, painful, hard masticatory muscles
| |
− | *Chronic stage = atrophic myositis
| |
− | **Atrophy may occur without previous acute stage
| |
− | *Grossly:
| |
− | **Bilateral but not necessarily symmetrical
| |
− | **At first, enlarged and oedematous muscles becominf dark red, firm with reddish streaks and yellowiss foci
| |
− | *Histologically:
| |
− | **Acute lesions:
| |
− | ***Mainly eosinophilic infiltrate, few lymphocytes, [[Monocytes - WikiBlood|monocytes]] and plasma cells
| |
− | ***In recurrent disease plasma cells predominate
| |
− | ***[[Muscles Degenerative - Pathology#Necrosis|Necrotic]] myofibres, [[Muscles Degenerative - Pathology#Atrophy|atrophy]] and attempted [[Muscle Regeneration - Anatomy & Physiology|regeneration]]
| |
− | **Chronic stage:
| |
− | ***[[Muscles Degenerative - Pathology#Atrophy|Atrophy]] predominates
| |
− | ***Fasciculi are shrunken
| |
− | ***Condensation of stroma -> enlarged endomysium
| |
− | ***Focal plasma cell and lymphocyte infiltration
| |
− | | |
− | ====[[Muscles Developmental - Pathology#Canine dermatomyositis|Canine dermatomyositis]]====
| |
− | | |
− | | |
− | ===Idiopathic myositis===
| |
− | | |
− | ====Canine polymyositis====
| |
− | | |
− | *DOES NOT include MMM above
| |
− | *Rare
| |
− | *Clinical signs:
| |
− | **Muscle pain
| |
− | **Fever
| |
− | **Weakness, particularly in hind limbs
| |
− | *Grossly:
| |
− | **Inflammation is accompanied by muscle necrosis and regeneration
| |
− | *Histologically:
| |
− | **Inflammatory foci with lymphocytes, plasma cells and occasionally eosinophils
| |
− | *Possibly immunological cause
| |
− | *Single biopsy may not be enough to make the diagnosis as it tends to be multifocal and disseminated
| |
− | *Lesions similar to some infectious causes (such as [[Toxoplasma|''Toxoplasma gondii'']])
| |
− | | |
− | ====Canine bilateral extraocular polymyositis====
| |
− | | |
− | *In Golden retrievers
| |
− | *Very rare
| |
− | *Clinical signs:
| |
− | **Acute bilateral exophthalmos
| |
− | *Involves only extraocular muscles except for retractor blbi
| |
− | *Grossly:
| |
− | **Swollen and pale extraocular muscles
| |
− | *Histologically:
| |
− | **Sterile myositis
| |
− | **Multifocal necrosis of myofibres
| |
− | **Lymphocytic, histiocytic and plasmacytic infiltrate with few [[Neutrophils - WikiBlood|neutrophils]]
| |
− | | |
− | | |
− | ====Bovine and ovine eosinophilic myositis====
| |
− | | |
− | *Unknown aetiology
| |
− | *Major cell involved is eosinphil
| |
− | *Usually noticed at slaughter - green muscle discoloration
| |
− | *May be caused by degenteration of [[Sarcocystis|''Sarcocystis'' spp.]]
| |
− | *Grossly:
| |
− | **Green discolored areas, well demarcated
| |
− | **Mostly in muscles of back and thighs
| |
− | *Histologically:
| |
− | **Massive eosinophil infiltration
| |
− | **Muscle fibres may degenerate
| |
− | **In old lesions - endimysial fibrosis, myofibre atrophy, some regeneration, lymphocytes, plasma cells, macrophages and few eosinophils
| |
− | **Capsule may form
| |