Hypovitaminosis D and Myosteatosis of Paraspinal Muscles

Myosteatosis is a pathological infiltration of fat in skeletal muscle reflecting an impairment in normal synthesis and elimination of triglyceride. Myosteatosis is associated with aging, type 2 diabetes, insulin resistance, and vitamin D deficiency. It is inversely related to loss of muscle strength and consequent disability. Lumbar paraspinal muscles are located on each side of the lumbar spine, attached to the vertebrae, providing necessary levels of trunk stability and trunk movement. We report a 65yearold woman with vitamin D deficiency, type 2 diabetes, and laboratory findings of secondary hyperparathyroidism. Her physical examination indicated dominantly pronounced walking difficulties due to the weakness of the paraspinal and pelvic muscles and the instability of the lower part of the vertebral column. Characteristic radiological features of expressive myosteatosis of paraspinal muscles were determined by magnetic resonance. The treatment of vitamin D, calcium and physical therapy over the course of one year did not block her progressive mobility disorder.