Correlation of muscle ultrasound with clinical and pathological findings in idiopathic inflammatory myopathies

Takeshi Yoshida, Hiroki Yamazaki, Yukako Nishimori, Naoko Takamatsu, Koji Fukushima, Yusuke Osaki, Yoshinori Taniguchi, Taiki Nozaki, Yoshitaka Kumon, Jemima Albayda, Ichizo Nishino, Yuishin Izumi

Research output: Contribution to journalArticlepeer-review

Abstract

Introduction/Aims: In idiopathic inflammatory myopathies (IIMs), the change in muscle echogenicity and its histopathological basis are not well understood. We quantitatively measured muscle echogenicity in patients with IIMs and evaluated its correlation with disease activity and histopathological findings. Methods: This study involved patients with IIMs who underwent both ultrasonography (US) and muscle biopsy, as well as age- and sex-matched rheumatoid arthritis patients as inflammatory disease controls. On US, axial images of the right biceps brachii and vastus medialis were obtained. Standardized histopathological scoring was used to quantitatively measure each pathological domain. Results: Forty-two patients (17 with inclusion body myositis [IBM] and 25 with IIMs other than IBM) and 25 controls were included. The muscle echo intensity (EI) of patients with IIMs was significantly higher than that of controls. Muscle EI showed significant correlations with creatine kinase (r = 0.66, p <.001) and muscle strength (r = −0.73, p <.0001) in patients with non-IBM IIMs. In patients with IBM, moderate correlation was found between muscle EI and quadriceps muscle strength (r = −0.53, p =.028). Histopathologically, the number of infiltrating CD3+ inflammatory cells correlated with muscle EI in the non-IBM group (r = 0.56, p =.017), but not in the IBM group. Discussion: Muscle EI may be useful as a surrogate marker of muscle inflammation in non-IBM IIM. Increased muscle EI may be difficult to interpret in patients with long-standing IBM, which has advanced and complex histopathology.

Original languageEnglish (US)
Pages (from-to)39-47
Number of pages9
JournalMuscle and Nerve
Volume68
Issue number1
DOIs
StatePublished - Jul 2023

Keywords

  • echogenicity
  • idiopathic inflammatory myopathies
  • imaging
  • muscle pathology
  • ultrasound

ASJC Scopus subject areas

  • Clinical Neurology
  • Physiology (medical)
  • Cellular and Molecular Neuroscience
  • Physiology

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