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Comparative Study
. 2018 Nov-Dec;36(6):996-1002.
Epub 2018 May 8.

Pattern of muscle involvement in inclusion body myositis: a sonographic study

Jemima Albayda  1 , Lisa Christopher-Stine  2 , Clifton O Bingham Iii  2 , Julie J Paik  2 , Eleni Tiniakou  2 , Seth Billings  3 , O Manny Uy  3 , Philippe Burlina  3
Affiliations
Comparative Study

Pattern of muscle involvement in inclusion body myositis: a sonographic study

Jemima Albayda et al. Clin Exp Rheumatol. 2018 Nov-Dec.

Abstract

Objectives: Imaging plays a role in myositis assessment by detecting muscle changes indicative of pathology. This study was conducted to determine the ultrasonographic pattern of muscle involvement in patients with inclusion body myositis (IBM) through an assessment of muscle echointensity.

Methods: Sixty-two individuals were consecutively studied, 18 with IBM, 16 with polymyositis or dermatomyositis and 28 normal controls. Standardised scans were completed bilaterally for the deltoids, biceps, flexor digitorum profundus (FDP), flexor carpi ulnaris, rectus femoris, tibialis anterior and gastrocnemius assessing for muscle echointensity changes.

Results: Patients with IBM had a markedly increased muscle echointensity when compared with comparator groups for all muscles studied. This was most discriminating at the FDP, gastrocnemius and rectus femoris. Asymmetry between sides and a heterogeneously increased echointensity were also seen.

Conclusions: Ultrasonography can aid in the assessment of IBM by displaying an increased echointensity in characteristically involved muscles, particularly when combined with assessments for asymmetry and echotexture.

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Figures

Fig. 1
Fig. 1
Mean muscle echointensities plotted by age in normal (+) vs. patients with myositis (o)
Fig. 2
Fig. 2. One-way analysis of variance (ANOVA) of muscle intensity means by diagnosis and muscle type using Tukey-Kramer HSD comparison of means. Separated circles indicate statistically significant differences in means.
Group 1: For the deltoids, biceps, FCR, and tibialis anterior all groups of myositis are significantly distinguishable from normal using mean muscle intensities. However, different myositis conditions are not distinguishable from each other. Overlapping circles and colors designate that there are no significant difference between those groups. For all these groups, the red circles denote normal, and show that the means do not overlap with those with myositis (separate circles). Group 2: For these three muscle groups, the separate red circles (IBM) indicate that the means do not overlap with those of myositis or normals. All these cases, the p-values among the diagnosis types were <0.001.
Fig. 3
Fig. 3. Representative images of IBM muscle involvement.
A) normal FDP (fd) and FCU (fc) muscles, B) FDP in IBM, atrophic with marked increase in echointensity, C) normal gastrocnemius (ga) and soleus (so) muscles, D) gastrocnemius in IBM with heterogeneously increased echointensity with “popcorn pattern”, E) and F) bilateral gastrocnemius muscles in the same IBM patient showing asymmetry. sc: subcutaneous tissue/fat.
See this image and copyright information in PMC

References

    1. NEEDHAM M, MASTAGLIA FL: Sporadic inclusion body myositis: A review of recent clinical advances and current approaches to diagnosis and treatment. Clin Neurophysiol 2016; 127: 1764–73. - PubMed
    1. HILTON-JONES D, BRADY S: Diagnostic criteria for inclusion body myositis. J Intern Med 2016; 280: 52–62. - PubMed
    1. TASCA G, MONFORTE M, DE FINO C et al.: Magnetic resonance imaging pattern recognition in sporadic inclusion-body myositis: Muscle MRI in IBM. Muscle Nerve 2015; 52: 956–62. - PubMed
    1. PHILLIPS BA, CALA LA, THICKBROOM GW et al.: Patterns of muscle involvement in inclusion body myositis: clinical and magnetic resonance imaging study. Muscle Nerve 2001; 24: 1526–34. - PubMed
    1. COX FM, REIJNIERSE M, VAN RIJSWIJK CSP et al.: Magnetic resonance imaging of skeletal muscles in sporadic inclusion body myositis. Rheumatology 2011; 50: 1153–61. - PubMed

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