How Imaging Can Assist with Diagnosis and Monitoring of Disease in Myositis
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INFLAMMATORY MUSCLE DISEASE (L DIEDERICHSEN AND H CHINOY, SECTION EDITORS)
How Imaging Can Assist with Diagnosis and Monitoring of Disease in Myositis K. Kubínová 1,2 & H. Mann 1,2 & J. Vrána 3 & Jiří Vencovský 1,2
# Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Purpose of Review To summarize recent findings and progression in the field of imaging of inflammatory myopathies. The most commonly used method is magnetic resonance imaging, and the article focuses on this technique, but covers also several other less frequently used or emerging methods. Recent Findings A relatively good agreement exists regarding some technical parameters, area of investigation, and assessment of inflammatory activity and chronic damage using magnetic resonance imaging. There are inconsistent data available with respect to distribution of involvement in individual IIM subtypes. Ultrasound and other imaging methods lack the validation and still face many unresolved problems. Summary Imaging plays a crucial role in the evaluation of impairment in patients with IIMs. The future research should be focused on standardization of each method in order to obtain comparable results and on defining the most appropriate indications of their use. Keywords Idiopathic inflammatory myopathy . Imaging . MRI . Ultrasound
Introduction Idiopathic inflammatory myopathies (IIM), usually subdivided into dermatomyositis (DM), polymyositis (PM), immune-mediated necrotizing myopathy (IMNM), overlap myositis (OM) with subgroup of anti-synthetase syndrome (ASS), and sporadic inclusion body myositis (sIBM), are rare diseases, which are often difficult to diagnose and even more challenging to manage. Except for DM with classical, pathognomonic cutaneous features [1, 2], the diagnosis of other IIM subtypes requires clinical, laboratory, electromyographic, as well as histopathological This article is part of the Topical Collection on Inflammatory Muscle Disease * Jiří Vencovský [email protected] 1
Institute of Rheumatology, Na Slupi 4, 12850 Prague, Czech Republic
2
Department of Rheumatology, 1st Faculty of Medicine, Charles University, Prague, Czech Republic
3
Department of Normal, Pathological and Clinical Physiology, 3rd Faculty of Medicine, Charles University, Prague, Czech Republic
testing. Imaging has been slowly integrated into the diagnostic process and became even incorporated in proposed classification criteria [3, 4]; however, the questions of its diagnostic value, reliability, and optimal evaluation protocol have not been clearly answered yet [5]. The most commonly used imaging method, magnetic resonance imaging (MRI), is currently undergoing a rapid development in the area of post-processing adjustments suitable for evaluation and quantifying of muscle morphological changes. Ultrasound, as a quick and widely available instrument allowing visualization of soft tissue, is becoming (especially in the hands of an experienced evaluator) to play an important role in detecting muscle pathologies [6]. Other well-establishe
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