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Association between muscle strength, histopathology, and magnetic resonance imaging in sporadic inclusion body myositis
Author(s) -
Dahlbom Kathe,
Geijer Mats,
Oldfors Anders,
Lindberg Christopher
Publication year - 2019
Publication title -
acta neurologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.967
H-Index - 95
eISSN - 1600-0404
pISSN - 0001-6314
DOI - 10.1111/ane.13040
Subject(s) - inclusion body myositis , biceps , atrophy , muscle biopsy , medicine , magnetic resonance imaging , myositis , muscle atrophy , anatomy , pathology , biopsy , muscle weakness , radiology
Objectives Inclusion body myositis is characterized by inflammatory and degenerative changes, but the temporal relation of these events is unknown. Materials and Methods In nineteen patients with inclusion body myositis, muscle strength was correlated with inflammatory and degenerative findings on magnetic resonance imaging (MRI) and in muscle biopsies in three different muscles (tibialis anterior, vastus lateralis, and biceps brachii). Muscle strength, measured with a handheld dynamometer, was described as percentage of muscle strength in age‐ and sex‐matched normal individuals. The muscles were categorized as the strongest, the intermediate, and the weakest muscle in each individual. T1‐weighted sequences on MRI were used to evaluate the degree of fatty infiltration and muscle atrophy and STIR sequences to evaluate edematous changes. Results The vastus lateralis, which in general was the weakest muscle, was significantly more atrophic compared to the other two muscles and also demonstrated most edema. The biceps brachii had in most cases an intermediate degree of weakness and atrophy but the most pronounced inflammatory cell infiltration on biopsy. Cytochrome c oxidase‐negative muscle fibers were significantly more prevalent in the vastus lateralis and biceps brachii muscles than in the tibialis anterior and thus correlated with muscular atrophy, indicating that this is a secondary change. Inflammatory changes as assessed by MRI and muscle biopsy were seen in all muscles irrespective of atrophy and thus appear to be prevalent at all stages of the disease. Conclusions Our study could not provide an answer to the question which comes first, the inflammation or the degenerative changes.