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MRI may detect disease activity in patients with myositis

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The use of MRI may add value to the detection of disease activity in patients with myositis compared to the measurement of serum creatine kinase levels, according to the results of a study.

Researchers studied 73 patients with myositis at two rheumatology centers including 34 patients with dermatomyositis (DM) and 39 patients with polymyositis (PM). Patients were diagnosed using Bohan and Peter criteria, and no treatment was followed by 33% of the patients.

Serum creatine kinase (sCK) was measured and MRI scans were acquired during the same visit. Seventeen thigh and pelvic floor muscles were assessed for edema on MRI and graded either 1 for the presence of edema or 0 for its absence. A composite edema score was calculated by adding the scores for each muscle bilaterally and dividing the score by two. A positive edema score was defined as one or higher and the sCK level was defined as positive in the presence of values above 190 U/L. Two radiologists collected the images with an intraclass correlation coefficient (ICC) of 0.78 between them. The Medical Research Council extended scale (0 to 5) was used to grade the outcomes of manual muscle testing (MMT) used to assess muscle weakness. Between the two physicians who performed the MMT, the was 0.8.

A discordant result between sCK and MRI was seen in 47% of the patients, and in 59% of patients with DM compared to 39% of patients with PM. Of patients who had a positive MRI and normal sCK, 56% had DM and 15% had PM.

Muscle strength in the hip flexors, bt not overall muscle strength, was significantly correlated with MRI scores, and MRI scores were not associated with sCK levels. No differences were observed between patients receiving treatment and patients who were undergoing treatment. – by Shirley Pulawski

Reference:

Pipitone N, et al. Paper #OP0278. Presented at: European League Against Rheumatism Annual European Congress of Rheumatology. June 10-13, 2015; Rome.

Disclosure: The researchers report no relevant financial disclosures.