Keywords:
Biological effects, Athletic injuries, Diagnostic procedure, Decision analysis, Computer Applications-Detection, diagnosis, Ultrasound, MR, CT-Quantitative, Musculoskeletal system, Musculoskeletal soft tissue, Extremities, Inflammation
Authors:
D. Dalili, T. M. Bansal, A. Isaac; London/UK
DOI:
10.1594/essr2018/P-0162
Conclusion
Myositis can be a diagnostic enigma.
Accuracy and timely diagnosis is key to patient survival and improving outcomes.
Assessment of symmetry,
distribution,
progression as well as any relevant drug and clinical history is mandatory to analysing findings seen on imaging.
Multimodality imaging offers various ways of assessing the underlying structures,
including architectural,
vascular and functional changes.
Awareness of possible pitfalls (transient reactive changes,
associated avulsion injuries and mimics like eosinophilic fasciitis and postoperative changes,
technical artefacts,
inadequate imaging) provide means for overcoming or avoiding these.
Blood tests are warranted to check for raised levels of enzymes and antibodies.
Correlation with EMGs can be useful to assess the remaining components of the neuromuscular unit.
Muscle biopsies remain the gold standard diagnostic tool for most of these conditions for histological correlation..
Family history is warranted in cases of neuromuscular diseases.
Genetic testing is performed for prognostic & genetic counselling as well as to aid the diagnosis in certain scenarios such as sporadic inclusion body myositis (sIBM) and Duchenne muscular dystrophy.
Treatment includes:
- Exercise and physiotherapy
- Nutrition
- Steroids
- Indomethacin
- Disease-modifying anti-rheumatic drugs (DMARDs)
- Intravenous immunoglobulin therapy
- Biologic therapies
- Gene therapy