School ager with a heliotrope rash, pain and proximal weakness

MRI of dermatomyositis
Axial T2 MRI through the hips (above) shows small patchy areas of increased T2 signal bilaterally and symmetrically in the gluteus muscles and in the subcutaneous tissues of the lateral and posterior thighs which show mild enhancement on axial T1 MRI with contrast (below).

The diagnosis was mild dermatomyositis.