{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,24]],"date-time":"2025-09-24T05:40:05Z","timestamp":1758692405868,"version":"3.44.0"},"reference-count":19,"publisher":"BMJ","issue":"9","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2025,9,2]]},"published-print":{"date-parts":[[2025,9]]},"abstract":"<jats:p>Scleroderma\u2013polymyositis overlap syndrome (SSc-PM) is an uncommon autoimmune condition characterised by clinical and serological features of both systemic sclerosis and inflammatory myopathy. Ocular manifestations of this syndrome are rare and insufficiently described in the literature. We report a case of SSc-PM presenting with orbital myositis as the primary manifestation, accompanied by proximal myopathy. A middle-aged woman presented with a 3-month history of progressive finger skin tightening, painless diplopia and restricted eye movements. Ophthalmological evaluation and imaging confirmed bilateral lateral rectus myositis. Laboratory investigations revealed elevated creatine kinase, positive antinuclear antibodies and anti-Ku antibody positivity. Following the rheumatology consultation, she was treated with intravenous methylprednisolone, transitioned to tapering oral prednisolone and initiated on mycophenolate mofetil. Her diplopia resolved completely and muscle enzyme levels normalised. Over 6\u2009months of follow-up, there was no progression of cutaneous or pulmonary disease. This case highlights orbital myositis as a rare but treatable manifestation of SSc-PM, underscoring the importance of early recognition and prompt immunosuppression in overlap syndromes.<\/jats:p>","DOI":"10.1136\/bcr-2025-267421","type":"journal-article","created":{"date-parts":[[2025,9,24]],"date-time":"2025-09-24T05:00:13Z","timestamp":1758690013000},"page":"e267421","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Orbital myositis: an uncommon ophthalmic presentation in scleroderma-polymyositis overlap syndrome"],"prefix":"10.1136","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-6680-8522","authenticated-orcid":false,"given":"Shan Kai","family":"Ing","sequence":"first","affiliation":[{"name":"Faculty of Medicine, SEGi University, Sibu Clinical Campus, Sibu, Sarawak, Malaysia"},{"name":"Department of Medicine, Sibu Hospital, Sibu, Sarawak, Malaysia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Guo Ruey","family":"Ling","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, SEGi University, Sibu Clinical Campus, Sibu, Sarawak, Malaysia"},{"name":"Division of Rheumatology, Department of Medicine, Sibu Hospital, Sibu, Sarawak, Malaysia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yih Hoong","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Medicine, Sibu Hospital, Sibu, Sarawak, Malaysia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Antony K","family":"Kuruvilla","sequence":"additional","affiliation":[{"name":"Department of Radiology, Sibu Hospital, Sibu, Sarawak, Malaysia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2025,9,23]]},"reference":[{"key":"2025092322000637000_18.9.e267421.1","doi-asserted-by":"crossref","first-page":"412","DOI":"10.1007\/s12016-022-08946-w","article-title":"Systemic Sclerosis-Specific Antibodies: Novel and Classical Biomarkers","volume":"64","author":"Cavazzana","year":"2023","journal-title":"Clin Rev Allergy Immunol"},{"key":"2025092322000637000_18.9.e267421.2","doi-asserted-by":"crossref","DOI":"10.1186\/ar4562","article-title":"Scleroderma-polymyositis overlap syndrome versus idiopathic polymyositis and systemic sclerosis: a descriptive study on clinical features and myopathology","volume":"16","author":"Bhansing","year":"2014","journal-title":"Arthritis Res Ther"},{"key":"2025092322000637000_18.9.e267421.3","first-page":"1583","article-title":"Skin thickness score in systemic sclerosis: an assessment of interobserver variability in 3 independent studies","volume":"36","author":"Clements","year":"1993","journal-title":"Arthritis Rheum"},{"key":"2025092322000637000_18.9.e267421.4","doi-asserted-by":"publisher","DOI":"10.1007\/s00296-006-0207-3"},{"key":"2025092322000637000_18.9.e267421.5","first-page":"e123","article-title":"Classification and management of overlap connective tissue diseases","volume":"4","author":"Fiorentino","year":"2022","journal-title":"Lancet Rheumatol"},{"key":"2025092322000637000_18.9.e267421.6","first-page":"48","article-title":"Epidemiology of systemic sclerosis: incidence, prevalence, survival, risk factors, malignancy, and environmental triggers","volume":"14","author":"Barnes","year":"2012","journal-title":"Curr Rheumatol Rep"},{"key":"2025092322000637000_18.9.e267421.7","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/kes315"},{"key":"2025092322000637000_18.9.e267421.8","doi-asserted-by":"crossref","first-page":"379","DOI":"10.1590\/S1807-59322011000300003","article-title":"Ocular findings in patients with systemic sclerosis","volume":"66","author":"de A. 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