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Abstract Number: 296

Different Patterns of Involvement of Thigh Muscles in Dermatomyositis and Polymyositis Using Fat-Suppressed Magnetic Resonance Sequences

Nicolo Pipitone1, Antonella Notarnicola2, Lucia Spaggiari3, Gabriele Levrini4, Arnaldo Scardapane5, Florenzo Iannone6, Giovanni Lapadula6, Giulio Zuccoli7 and Carlo Salvarani8, 1Unità di Reumatologia, Reggio Emilia, Arcispedale Santa Maria Nuova, Bari, Italy, 2Karolinska Hospital, Rheumatology Unit, Stockholm, Sweden, 3Radiology, Arcispedale S Maria Nuova, Reggio Emilia, Italy, 4Arcispedale S Maria Nuova, Reggio Emilia, Italy, 5Radiology, University of Bari, Bari, Italy, 6Bari University, Rheumatology, Bari, Italy, 7Children's Hospital of Pittsburgh, Pittsburgh, PA, 8Rheumatology, Arcispedale S.Maria Nuova, Reggio Emilia, Italy

Meeting: 2015 ACR/ARHP Annual Meeting

Date of first publication: September 29, 2015

Keywords: dermatomyositis, Magnetic resonance imaging (MRI), myositis and polymyositis

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Session Information

Date: Sunday, November 8, 2015

Title: Muscle Biology, Myositis and Myopathies Poster

Session Type: ACR Poster Session A

Session Time: 9:00AM-11:00AM

Background/Purpose: MRI is often used to evaluate muscle inflammation in myositis. Muscle edema on fat-suppressed (short tau inversion recovery, STIR) sequences is thought to represent active inflammation. Dermatomyositis (DM) and polymyositis (PM) affect very often thigh muscles. However, it is unclear whether DM and PM differ in the respective involvement of the various thigh muscle groups. In this study, we aimed to assess which thigh muscle groups are preferentially inflamed in DM and PM, respectively, using MRI fat-suppressed sequences.

Methods: We analysed 72 patients from 2 Rheumatology centers (Reggio Emilia & Bari, Italy), 31 with DM and 41 with PM diagnosed according to Bohan and Peter criteria. MRI edema (1= present, 0= absent) was assessed bilaterally on STIR sequences in 17 thigh/pelvic floor muscles. An MRI composite edema score (0-17) was calculated by adding the separate scores bilaterally and dividing them by two as described in Clin Exp Rheumatol 2012; 30:570. The (single measures) intraclass correlation coefficient (ICC) between the Radiologists involved was 0.78. Fisher’s exact test was used for comparison of binomial data.

Results: Age (years, mean±SD) was similar in patients with DM (53 ± 16) and PM (56 ± 16). The F:M ratio was similar in DM (23/8) and PM (32/9). Disease duration (months, mean±SD) was shorter (20±31) in DM than in PM (52±68) (p=0.02).  The Table shows the frequency (n° and %) of all thigh muscle groups involved in DM and PM. 

TABLE

Compartment

DM (n=31)

PM (n=41)

p value

 

 

 

 

 

Gluteus maximus

axial

17 (55%)

13 (32%)

0.06

Quadratus femoris

axial

9 (29%)

1 (2%)

0.002

Vastus lateralis

anterior

15 (48%)

11 (27%)

0.08

Ileopsoas

axial

8 (26%)

3 (7%)

0.046

Vastus medialis

anterior

14 (45%)

10 (24%)

0.08

Tensor fasciae latae

anterior

12 (39%)

4 (10%)

0.005

Rectus femoris

anterior

16 (52%)

10 (24%)

0.03

Sartorius

anterior

13 (42%)

11 (27%)

0.2

Gracilis

medial

15 (48%)

8 (20%)

0.01

Pectineus

medial

8 (26%)

2 (5%)

0.02

Adductor longus

medial

9 (29%)

6 (15%)

0.16

Adductor brevis

medial

12 (39%)

5 (12%)

0.01

Adductor magnus

medial

10 (32%)

10 (24%)

0.6

Short head biceps femoris

posterior

10 (32%)

6 (15%)

0.09

Long head biceps femoris

posterior

12 (39%)

12 (29%)

0.5

Semimembranous

posterior

10 (32%)

8 (20%)

0.3

Semitendineous

posterior

14 (45%)

10 (24%)

0.08

Conclusion: Compared with PM, DM affects more frequently some muscle groups. Posterior muscle groups discriminate poorly between DM and PM. These findings may be useful for differential diagnostic purposes in patients with histological DM without the typical skin rash as well as to target physiotherapy at more frequently affected muscles.


Disclosure: N. Pipitone, None; A. Notarnicola, None; L. Spaggiari, None; G. Levrini, None; A. Scardapane, None; F. Iannone, None; G. Lapadula, None; G. Zuccoli, None; C. Salvarani, None.

To cite this abstract in AMA style:

Pipitone N, Notarnicola A, Spaggiari L, Levrini G, Scardapane A, Iannone F, Lapadula G, Zuccoli G, Salvarani C. Different Patterns of Involvement of Thigh Muscles in Dermatomyositis and Polymyositis Using Fat-Suppressed Magnetic Resonance Sequences [abstract]. Arthritis Rheumatol. 2015; 67 (suppl 10). https://acrabstracts.org/abstract/different-patterns-of-involvement-of-thigh-muscles-in-dermatomyositis-and-polymyositis-using-fat-suppressed-magnetic-resonance-sequences/. Accessed .
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