Intramuscular cysticercosis: starry sky appearance

Abstract

### Learning Point for Clinicians Cysticercosis is now seen as a global disease affecting the whole world, and clinicians should be aware of the typical clinical presentations and imaging findings of rice-like or starry sky appearance in order to avoid misdiagnosis and thereby instituting appropriate treatment. A 28-year-old man without significant medical history presented to our hospital for premarital health checkup. On clinical examination, several lumps were palpated in the skin of the entire body, with arms and legs predominance. No other clinical abnormalities were found, with normal neurological and opthalmological examinations. Past history revealed occasional eating of several kinds of raw meat during his stay in the rural mountainous region. Blood tests revealed normal hematocrit profile and WBC count. Radiographs were performed which revealed numerous rice-like ovoid calcified lesions resembling starry sky appearance in the abdomen and lower extremities with lower limb predominance (Figure 1, Panel A). Considering high suspicion for parasitic infestation, magnetic resonance imaging (MRI) of the lower extremities was performed for better …