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Review
. 2018 Nov;30(6):606-613.
doi: 10.1097/BOR.0000000000000549.

Recent developments in classification criteria and diagnosis guidelines for idiopathic inflammatory myopathies

Alexander Oldroyd  1   2   3 , Hector Chinoy  1   2   3
Affiliations
Review

Recent developments in classification criteria and diagnosis guidelines for idiopathic inflammatory myopathies

Alexander Oldroyd et al. Curr Opin Rheumatol. 2018 Nov.

Abstract

Purpose of review: The aim of this review was to summarize key developments in classification and diagnosis of the idiopathic inflammatory myopathies (IIMs).

Recent findings: The recently published European League Against Rheumatism/American College of Rheumatology (EULAR/ACR) classification criteria for the IIMs provide a comprehensive, accurate and data-driven approach to identification of IIM cases appropriate for inclusion in research studies. Further, recent studies have advanced understanding of clinical manifestations of the IIMs and delineated the role of imaging, particularly magnetic resonance.

Summary: The recent publication of the EULAR/ACR classification criteria will potentially greatly improve IIM research through more accurate case identification and standardization across studies.Future inclusion of newly recognized clinical associations with the MSAs may further improve the criteria's accuracy and utility. Clear and comprehensive understanding of associations between clinical manifestations, prognosis and multisystem involvement can aid diagnostic assessment; recent advances include delineation of such associations and expansion of the role of imaging.

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Figures

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FIGURE 1
FIGURE 1
Classification tree for subtype of idiopathic inflammatory myopathies. ADM, amyopathic dermatomyositis; DM, dermatomyositis; EULAR/ACR, European League Against Rheumatism/American College of Rheumatology; IBM, inclusion body myositis; IMNM, immune-mediated necrotising myopathy; JDM, juvenile dermatomyositis; PM, polymyositis. For inclusion body myositis (IBM) classification, one of the following is required for classification: finger flexor weakness and response to treatment: not improved (a), or muscle biopsy: rimmed vacuoles (b). cJuvenile myositis other than juvenile dermatomyositis was developed based on expert opinion. Adapted with permission [▪▪].
See this image and copyright information in PMC

References

    1. Oldroyd A, Lilleker J, Chinoy H. Idiopathic inflammatory myopathies: a guide to subtypes, diagnostic approach and treatment. Clin Med (Lond) 2017; 17:322–328. - PMC - PubMed
    1. Bohan A, Peter JB. Polymyositis and dermatomyositis (first of two parts). N Engl J Med 1975; 292:344–347. - PubMed
    1. Bohan A, Peter JB. Polymyositis and dermatomyositis (second of two parts). N Engl J Med 1975; 292:403–407. - PubMed
    1. Lundberg IE, Tjärnlund A, Bottai M, et al. 2017 European League Against Rheumatism/American College of Rheumatology classification criteria for adult and juvenile idiopathic inflammatory myopathies and their major subgroups. Ann Rheum Dis 2017; 76:1955–1964. - PMC - PubMed

    2. This study describes the recently published classification criteria. The data-driven approach and consideration of a wide range of candidate variables make these criteria the most accurate and valid to date.

    1. Tanimoto K, Nakano K, Kano S, et al. Classification criteria for polymyositis and dermatomyositis. J Rheumatol 1995; 22:668–674. - PubMed

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