Semin Musculoskelet Radiol 2010; 14(2): 217-226
DOI: 10.1055/s-0030-1253163
© Thieme Medical Publishers

The Myositides: The Role of Imaging in Diagnosis and Treatment

Waseem A. Bashir1 , 2 , Paul O'Donnell2
  • 1Department of Radiology, Ealing Hospital NHS Trust, London, United Kingdom
  • 2Department of Radiology, The Royal National Orthopaedic Hospital, Middlesex, London, United Kingdom
Further Information

Publication History

Publication Date:
18 May 2010 (online)

ABSTRACT

The entities encompassing the syndromes collectively known as myopathies and myositis are composed of numerous separate and distinct disorders with a vast spectrum of clinical signs, symptoms, immunopathology, genetic and environmental influences, as well as overall clinical outcome. Classification of the myositides (diseases of skeletal muscle) remains a rather controversial subject due to our lack of complete understanding of this divergent group of disorders. The mainstay of achieving diagnosis of a myopathy has until relatively recently been with a combination of clinical acumen, laboratory assessment, electromyography, and muscle biopsy. The use of modern high-resolution cross-sectional imaging studies is of particular value in confirming the physical findings and identifying suitable sites for biopsy. Imaging is fast becoming an established part of the overall evaluation of myopathies and myositis, helping to delineate the location and extent of the disease process, and it is being recognized as central to a prompt and accurate diagnosis in some cases. Although radiology has mainly been seen to have a subsidiary role in the diagnosis of myositides, newer imaging techniques following recent determined research interests have began to spark a renewed interest in the complex field of skeletal muscle imaging.

REFERENCES

  • 1 Cardamone M, Darras B T, Ryan M M. Inherited myopathies and muscular dystrophies.  Semin Neurol. 2008;  28(2) 250-259
  • 2 DiMauro S. Mitochondrial myopathies.  Curr Opin Rheumatol. 2006;  18(6) 636-641
  • 3 D'Amico A, Bertini E. Congenital myopathies.  Curr Neurol Neurosci Rep. 2008;  8(1) 73-79
  • 4 Owczarek J, Jasińska M, Orszulak-Michalak D. Drug-induced myopathies. An overview of the possible mechanisms.  Pharmacol Rep. 2005;  57(1) 23-34
  • 5 Delaney-Sathy L O, Fessell D P, Jacobson J A, Hayes C W. Sonography of diabetic muscle infarction with MR imaging, CT, and pathologic correlation.  AJR Am J Roentgenol. 2000;  174(1) 165-169
  • 6 Murphey M D, Quale J L, Martin N L, Bramble J M, Cook L T, Dwyer III S J. Computed radiography in musculoskeletal imaging: state of the art.  AJR Am J Roentgenol. 1992;  158(1) 19-27
  • 7 Otake S, Ishigaki T. Muscular sarcoidosis.  Semin Musculoskelet Radiol. 2001;  5(2) 167-170
  • 8 Stonecipher M R, Jorizzo J L, Monu J, Walker F, Sutej P G. Dermatomyositis with normal muscle enzyme concentrations. A single-blind study of the diagnostic value of magnetic resonance imaging and ultrasound.  Arch Dermatol. 1994;  130(10) 1294-1299
  • 9 O'Connell M J, Powell T, Brennan D, Lynch T, McCarthy C J, Eustace S J. Whole-body MR imaging in the diagnosis of polymyositis.  AJR Am J Roentgenol. 2002;  179(4) 967-971
  • 10 Garcia J. MRI in inflammatory myopathies.  Skeletal Radiol. 2000;  29(8) 425-438
  • 11 Hernandez R J, Keim D R, Chenevert T L, Sullivan D B, Aisen A M. Fat-suppressed MR imaging of myositis.  Radiology. 1992;  182(1) 217-219
  • 12 Trusen A, Beissert M, Schultz G, Chittka B, Darge K. Ultrasound and MRI features of pyomyositis in children.  Eur Radiol. 2003;  13(5) 1050-1055
  • 13 Veenstra D L, Best J H, Hornberger J, Sullivan S D, Hricik D E. Incidence and long-term cost of steroid-related side effects after renal transplantation.  Am J Kidney Dis. 1999;  33(5) 829-839
  • 14 Schweitzer M E, Fort J. Cost-effectiveness of MR imaging in evaluating polymyositis.  AJR Am J Roentgenol. 1995;  165(6) 1469-1471
  • 15 Patten C, Meyer R A, Fleckenstein J L. T2 mapping of muscle.  Semin Musculoskelet Radiol. 2003;  7(4) 297-305
  • 16 Qi J, Olsen N J, Price R R, Winston J A, Park J H. Diffusion-weighted imaging of inflammatory myopathies: polymyositis and dermatomyositis.  J Magn Reson Imaging. 2008;  27(1) 212-217
  • 17 Gold G E. Dynamic and functional imaging of the musculoskeletal system.  Semin Musculoskelet Radiol. 2003;  7(4) 245-248
  • 18 Reimers C D, Finkenstaedt M. Muscle imaging in inflammatory myopathies.  Curr Opin Rheumatol. 1997;  9(6) 475-485
  • 19 Batz R, Sofka C M, Adler R S, Mintz D N, Dicarlo E. Dermatomyositis and calcific myonecrosis in the leg: ultrasound as an aid in management.  Skeletal Radiol. 2006;  35(2) 113-116
  • 20 Reimers C D, Fleckenstein J L, Witt T N, Müller-Felber W, Pongratz D E. Muscular ultrasound in idiopathic inflammatory myopathies of adults.  J Neurol Sci. 1993;  116(1) 82-92
  • 21 Weber M A, Krix M, Jappe U et al.. Pathologic skeletal muscle perfusion in patients with myositis: detection with quantitative contrast-enhanced US—initial results.  Radiology. 2006;  238(2) 640-649
  • 22 Gennisson J L, Cornu C, Catheline S, Fink M, Portero P. Human muscle hardness assessment during incremental isometric contraction using transient elastography.  J Biomech. 2005;  38(7) 1543-1550
  • 23 Cetin C, Sekir U, Yildiz Y, Aydin T, Ors F, Kalyon T A. Chronic groin pain in an amateur soccer player.  Br J Sports Med. 2004;  38(2) 223-224
  • 24 Kransdorf M J, Meis J M, Jelinek J S. Myositis ossificans: MR appearance with radiologic-pathologic correlation.  AJR Am J Roentgenol. 1991;  157(6) 1243-1248
  • 25 Kagen LJ The Inflammatory Myopathies. New York, NY; Humana Press 2009
  • 26 Campellone J V, Lacomis D, Giuliani M J, Oddis C V. Percutaneous needle muscle biopsy in the evaluation of patients with suspected inflammatory myopathy.  Arthritis Rheum. 1997;  40(10) 1886-1891
  • 27 Adams E M, Chow C K, Premkumar A, Plotz P H. The idiopathic inflammatory myopathies: spectrum of MR imaging findings.  Radiographics. 1995;  15(3) 563-574
  • 28 Gordon B A, Martinez S, Collins A J. Pyomyositis: characteristics at CT and MR imaging.  Radiology. 1995;  197(1) 279-286
  • 29 Wysoki M G, Santora T A, Shah R M, Friedman A C. Necrotizing fasciitis: CT characteristics.  Radiology. 1997;  203(3) 859-863
  • 30 Schmid M R, Kossmann T, Duewell S. Differentiation of necrotizing fasciitis and cellulitis using MR imaging.  AJR Am J Roentgenol. 1998;  170(3) 615-620
  • 31 Restrepo C S, Lemos D F, Gordillo H et al.. Imaging findings in musculoskeletal complications of AIDS.  Radiographics. 2004;  24(4) 1029-1049
  • 32 Berger C, Sommer C, Meinck H M. Isolated sarcoid myopathy.  Muscle Nerve. 2002;  26(4) 553-556
  • 33 Otake S, Ishigaki T. Muscular sarcoidosis.  Semin Musculoskelet Radiol. 2001;  5(2) 167-170
  • 34 Friedman Y, Paul J T, Turley J, Hazrati L N, Munoz D. Axial myopathy due to primary amyloidosis.  Muscle Nerve. 2007;  36(4) 542-546
  • 35 Worthmann F, Bruns J, Türker T, Gosztonyi G. Muscular involvement in Behçet's disease: case report and review of the literature.  Neuromuscul Disord. 1996;  6(4) 247-253
  • 36 Lamminen A E, Hekali P E, Tiula E, Suramo I, Korhola O A. Acute rhabdomyolysis: evaluation with magnetic resonance imaging compared with computed tomography and ultrasonography.  Br J Radiol. 1989;  62(736) 326-330
  • 37 Shintani S, Shiigai T. Repeat MRI in acute rhabdomyolysis: correlation with clinicopathological findings.  J Comput Assist Tomogr. 1993;  17(5) 786-791
  • 38 Magee T, Rosenthal H. Skeletal muscle metastases at sites of documented trauma.  AJR Am J Roentgenol. 2002;  178(4) 985-988
  • 39 Lee V S, Martinez S, Coleman R E. Primary muscle lymphoma: clinical and imaging findings.  Radiology. 1997;  203(1) 237-244
  • 40 Holobinko J N, Damron T A, Scerpella P R, Hojnowski L. Calcific myonecrosis: keys to early recognition.  Skeletal Radiol. 2003;  32(1) 35-40
  • 41 Pagonidis K, Raissaki M, Gourtsoyiannis N. Proliferative myositis: value of imaging.  J Comput Assist Tomogr. 2005;  29(1) 108-111
  • 42 Callen J P. Relationship of cancer to inflammatory muscle diseases. Dermatomyositis, polymyositis, and inclusion body myositis.  Rheum Dis Clin North Am. 1994;  20(4) 943-953
  • 43 O'Neill J H, Murray N M, Newsom-Davis J. The Lambert-Eaton myasthenic syndrome: a review of 50 cases.  Brain. 1988;  111 577-596
  • 44 Elsayes K M, Lammle M, Shariff A, Totty W G, Habib I F, Rubin D A. Value of magnetic resonance imaging in muscle trauma.  Curr Probl Diagn Radiol. 2006;  35(5) 206-212
  • 45 Bashir W A, Connell D A. Imaging of entrapment and compressive neuropathies.  Semin Musculoskelet Radiol. 2008;  12(2) 170-181

Waseem A BashirM.R.C.P.(UK) 

Department of Radiology, Ealing Hospital NHS Trust

Uxbridge Road, London UB1 3HW UK

Email: wabashir@doctors.net.uk

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