Abstract: The authors report the case of a 62-year-old man with a history of total left hip arthroplasty nine years previously presenting with a large infiltrated plaque on the posterior area of the left thigh with three months of evolution without systemic symptoms or elevated inflammatory markers. Computed tomography of the left lower limb revealed a 12-centimeter linear extension of the lesion to the posterior part of the left proximal femur. Prosthesis joint infection, although rare, is a surgical complication to be taken into account, even if the surgery was performed many years before.

A Dermatomiosite Juvenil é uma doença muscular inflamatória rara na infância, de natureza auto-imune e de etiologia desconhecida. Os critérios diagnósticos incluem manifestações clínicas musculo-esqueléticas e cutâneas, aumento das enzimas musculares, alterações na electromiografia e miosite na biópsia muscular. A ressonância magnética nuclear é útil na idade pediátrica para orientação diagnóstica. O tratamento de base é a corticoterapia. Outros imunosupressores (Metrotexato, Ciclosporina) também podem ser usados. O prognóstico da doença é favorável na maioria dos casos. Os autores descrevem o caso de uma criança de quatro anos com internamentos recorrentes por atingimento do estado geral e queixas músculo-esqueléticas inespecíficas. O aparecimento de lesões cutâneas a nível das mãos e cotovelos indiciaram o diagnóstico de Dermatomiosite Juvenil.

Juvenile Dermatomyositis is an idiopathic inflammatory myopathy. it is a rare, autoimmune disorder in childhood, with unknown etiology. The diagnostic criteria consist of musculoskeletal and cutaneous manifestations, raised muscle enzymes, electromyographic abnormalities and myositis revealed by muscle biopsy. Mri is also an important diagnostic tool in pediatric patients. The treatment basis is corticotherapy. imunosupressant drugs such as methotrexate and cyclosporine may also be used. Prognosis is good in most patients. The case describes a four year-old child, who was recurrently admitted in hospital with constitutional and musculoskeletal symptoms and signs. The appearance of a typical skin rash on both hands and elbows allowed the diagnostic of probable Juvenile Dermatomyositis.