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Semin Musculoskelet Radiol 2018; 22(03): 286-298
DOI: 10.1055/s-0038-1641572
Review Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Myositis and Fasciitis: Role of Imaging

Yoshimi Endo
1   Department of Radiology and Imaging, Hospital for Special Surgery, New York, New York
,
Theodore T. Miller
1   Department of Radiology and Imaging, Hospital for Special Surgery, New York, New York
› Author Affiliations
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Publication History

Publication Date:
23 May 2018 (online)

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Abstract

Imaging plays an important role in the evaluation of patients presenting with possible myositis, with magnetic resonance imaging the most appropriate modality but ultrasound also playing a complementary role. This article reviews the imaging appearance of the inflammatory myopathies, other forms of myositis, and mimickers of myositis, with a discussion of distinguishing features for each entity. The fascia and disease processes that preferentially involve the fascia are also reviewed.

Keywords

myositis - myopathy - fasciitis - magnetic resonance imaging - ultrasound
 

  • References

  • 1 Delfaut EM, Beltran J, Johnson G, Rousseau J, Marchandise X, Cotten A. Fat suppression in MR imaging: techniques and pitfalls. Radiographics 1999; 19 (02) 373-382
    CrossrefPubMedGoogle Scholar
  • 2 Andreisek G, Crook DW, Burg D, Marincek B, Weishaupt D. Peripheral neuropathies of the median, radial, and ulnar nerves: MR imaging features. Radiographics 2006; 26 (05) 1267-1287
    CrossrefPubMedGoogle Scholar
  • 3 Day J, Patel S, Limaye V. The role of magnetic resonance imaging techniques in evaluation and management of the idiopathic inflammatory myopathies. Semin Arthritis Rheum 2017; 46 (05) 642-649
    CrossrefPubMedGoogle Scholar
  • 4 Filli L, Winklhofer S, Andreisek G, Del Grande F. Imaging of myopathies. Radiol Clin North Am 2017; 55 (05) 1055-1070
    CrossrefPubMedGoogle Scholar
  • 5 Garcia J. MRI in inflammatory myopathies. Skeletal Radiol 2000; 29 (08) 425-438
    CrossrefPubMedGoogle Scholar
  • 6 Adler RS, Garofalo G. Ultrasound in the evaluation of the inflammatory myopathies. Curr Rheumatol Rep 2009; 11 (04) 302-308
    CrossrefPubMedGoogle Scholar
  • 7 Woodhouse JB, McNally EG. Ultrasound of skeletal muscle injury: an update. Semin Ultrasound CT MR 2011; 32 (02) 91-100
    CrossrefPubMedGoogle Scholar
  • 8 Connell DA, Schneider-Kolsky ME, Hoving JL. , et al. Longitudinal study comparing sonographic and MRI assessments of acute and healing hamstring injuries. AJR Am J Roentgenol 2004; 183 (04) 975-984
    CrossrefPubMedGoogle Scholar
  • 9 Campbell SE, Adler R, Sofka CM. Ultrasound of muscle abnormalities. Ultrasound Q 2005; 21 (02) 87-94 , quiz 150, 153–154
    PubMedGoogle Scholar
  • 10 O'Connell MJ, Powell T, Brennan D, Lynch T, McCarthy CJ, Eustace SJ. Whole-body MR imaging in the diagnosis of polymyositis. AJR Am J Roentgenol 2002; 179 (04) 967-971
    CrossrefPubMedGoogle Scholar
  • 11 Fujitake J, Ishikawa Y, Fujii H, Nishimura K, Hayakawa K, Tatsuoka Y. Magnetic resonance imaging of skeletal muscles in the polymyositis. Muscle Nerve 1997; 20 (11) 1463-1466
    CrossrefPubMedGoogle Scholar
  • 12 Dion E, Cherin P, Payan C. , et al. Magnetic resonance imaging criteria for distinguishing between inclusion body myositis and polymyositis. J Rheumatol 2002; 29 (09) 1897-1906
    PubMedGoogle Scholar
  • 13 Cantwell C, Ryan M, O'Connell M. , et al. A comparison of inflammatory myopathies at whole-body turbo STIR MRI. Clin Radiol 2005; 60 (02) 261-267
    CrossrefPubMedGoogle Scholar
  • 14 Reimers CD, Schedel H, Fleckenstein JL. , et al. Magnetic resonance imaging of skeletal muscles in idiopathic inflammatory myopathies of adults. J Neurol 1994; 241 (05) 306-314
    CrossrefPubMedGoogle Scholar
  • 15 Schulze M, Kötter I, Ernemann U. , et al. MRI findings in inflammatory muscle diseases and their noninflammatory mimics. AJR Am J Roentgenol 2009; 192 (06) 1708-1716
    CrossrefPubMedGoogle Scholar
  • 16 Lamminen AE. Magnetic resonance imaging of primary skeletal muscle diseases: patterns of distribution and severity of involvement. Br J Radiol 1990; 63 (756) 946-950
    CrossrefPubMedGoogle Scholar
  • 17 Elessawy SS, Abdelsalam EM, Abdel Razek E, Tharwat S. Whole-body MRI for full assessment and characterization of diffuse inflammatory myopathy. Acta Radiol Open 2016; 5 (09) 2058460116668216
    PubMedGoogle Scholar
  • 18 Yoshida K, Kurosaka D, Joh K. , et al. Fasciitis as a common lesion of dermatomyositis, demonstrated early after disease onset by en bloc biopsy combined with magnetic resonance imaging. Arthritis Rheum 2010; 62 (12) 3751-3759
    CrossrefPubMedGoogle Scholar
  • 19 Yoshida K, Nishioka M, Matsushima S. , et al. Brief report: Power Doppler ultrasonography for detection of increased vascularity in the fascia: a potential early diagnostic tool in fasciitis of dermatomyositis. Arthritis Rheumatol 2016; 68 (12) 2986-2991
    CrossrefPubMedGoogle Scholar
  • 20 Blane CE, White SJ, Braunstein EM, Bowyer SL, Sullivan DB. Patterns of calcification in childhood dermatomyositis. AJR Am J Roentgenol 1984; 142 (02) 397-400
    CrossrefPubMedGoogle Scholar
  • 21 Paltiel AD, Ingvarsson E, Lee DK. , et al. Demographic and clinical features of inclusion body myositis in North America. Muscle Nerve 2015; 52 (04) 527-533
    CrossrefPubMedGoogle Scholar
  • 22 Cox FM, Reijnierse M, van Rijswijk CS, Wintzen AR, Verschuuren JJ, Badrising UA. Magnetic resonance imaging of skeletal muscles in sporadic inclusion body myositis. Rheumatology (Oxford) 2011; 50 (06) 1153-1161
    CrossrefPubMedGoogle Scholar
  • 23 Guimaraes JB, Zanoteli E, Link TM. , et al. Sporadic inclusion body myositis: MRI findings and correlation with clinical and functional parameters. AJR Am J Roentgenol 2017; 209 (06) 1340-1347
    CrossrefPubMedGoogle Scholar
  • 24 Phillips BA, Cala LA, Thickbroom GW, Melsom A, Zilko PJ, Mastaglia FL. Patterns of muscle involvement in inclusion body myositis: clinical and magnetic resonance imaging study. Muscle Nerve 2001; 24 (11) 1526-1534
    CrossrefPubMedGoogle Scholar
  • 25 Tasca G, Monforte M, De Fino C, Kley RA, Ricci E, Mirabella M. Magnetic resonance imaging pattern recognition in sporadic inclusion-body myositis. Muscle Nerve 2015; 52 (06) 956-962
    CrossrefPubMedGoogle Scholar
  • 26 Ten Dam L, van der Kooi AJ, Verhamme C, Wattjes MP, de Visser M. Muscle imaging in inherited and acquired muscle diseases. Eur J Neurol 2016; 23 (04) 688-703
    CrossrefPubMedGoogle Scholar
  • 27 Kransdorf MJ, Meis JM, Jelinek JS. Myositis ossificans: MR appearance with radiologic-pathologic correlation. AJR Am J Roentgenol 1991; 157 (06) 1243-1248
    CrossrefPubMedGoogle Scholar
  • 28 Subhawong TK, Fishman EK, Swart JE, Carrino JA, Attar S, Fayad LM. Soft-tissue masses and masslike conditions: what does CT add to diagnosis and management?. AJR Am J Roentgenol 2010; 194 (06) 1559-1567
    CrossrefPubMedGoogle Scholar
  • 29 Heiken JP, Lee JK, Smathers RL, Totty WG, Murphy WA. CT of benign soft-tissue masses of the extremities. AJR Am J Roentgenol 1984; 142 (03) 575-580
    CrossrefPubMedGoogle Scholar
  • 30 Bouchardy L, Garcia J. Magnetic resonance imaging in the diagnosis of myositis ossificans circumscripta [in French]. J Radiol 1994; 75 (02) 101-110
    PubMedGoogle Scholar
  • 31 De Smet AA, Norris MA, Fisher DR. Magnetic resonance imaging of myositis ossificans: analysis of seven cases. Skeletal Radiol 1992; 21 (08) 503-507
    CrossrefPubMedGoogle Scholar
  • 32 Abate M, Salini V, Rimondi E. , et al. Post traumatic myositis ossificans: sonographic findings. J Clin Ultrasound 2011; 39 (03) 135-140
    CrossrefPubMedGoogle Scholar
  • 33 Tyler P, Saifuddin A. The imaging of myositis ossificans. Semin Musculoskelet Radiol 2010; 14 (02) 201-216
    Article in Thieme ConnectPubMedGoogle Scholar
  • 34 Lee KR, Park SY, Jin W, Won KY. MR imaging and ultrasonography findings of early myositis ossificans: a case report. Skeletal Radiol 2016; 45 (10) 1413-1417
    CrossrefPubMedGoogle Scholar
  • 35 Crum NF. Bacterial pyomyositis in the United States. Am J Med 2004; 117 (06) 420-428
    CrossrefPubMedGoogle Scholar
  • 36 Hayeri MR, Ziai P, Shehata ML, Teytelboym OM, Huang BK. Soft-tissue infections and their imaging mimics: from cellulitis to necrotizing fasciitis. Radiographics 2016; 36 (06) 1888-1910
    CrossrefPubMedGoogle Scholar
  • 37 Bickels J, Ben-Sira L, Kessler A, Wientroub S. Primary pyomyositis. J Bone Joint Surg Am 2002; 84-A (12) 2277-2286
    PubMedGoogle Scholar
  • 38 Gordon BA, Martinez S, Collins AJ. Pyomyositis: characteristics at CT and MR imaging. Radiology 1995; 197 (01) 279-286
    CrossrefPubMedGoogle Scholar
  • 39 Fleckenstein JL, Burns DK, Murphy FK, Jayson HT, Bonte FJ. Differential diagnosis of bacterial myositis in AIDS: evaluation with MR imaging. Radiology 1991; 179 (03) 653-658
    CrossrefPubMedGoogle Scholar
  • 40 Steinbach LS, Tehranzadeh J, Fleckenstein JL, Vanarthos WJ, Pais MJ. Human immunodeficiency virus infection: musculoskeletal manifestations. Radiology 1993; 186 (03) 833-838
    CrossrefPubMedGoogle Scholar
  • 41 Miller TT, Randolph Jr DA, Staron RB, Feldman F, Cushin S. Fat-suppressed MRI of musculoskeletal infection: fast T2-weighted techniques versus gadolinium-enhanced T1-weighted images. Skeletal Radiol 1997; 26 (11) 654-658
    CrossrefPubMedGoogle Scholar
  • 42 Bureau NJ, Chhem RK, Cardinal E. Musculoskeletal infections: US manifestations. Radiographics 1999; 19 (06) 1585-1592
    CrossrefPubMedGoogle Scholar
  • 43 Devic P, Gallay L, Streichenberger N, Petiot P. Focal myositis: a review. Neuromuscul Disord 2016; 26 (11) 725-733
    CrossrefPubMedGoogle Scholar
  • 44 Gaeta M, Mazziotti S, Minutoli F. , et al. MR imaging findings of focal myositis: a pseudotumour that may mimic muscle neoplasm. Skeletal Radiol 2009; 38 (06) 571-578
    CrossrefPubMedGoogle Scholar
  • 45 Llauger J, Bagué S, Palmer J, Matías-Guiu X, San Román L, Doncel A. Focal myositis of the thigh: unusual MR pattern. Skeletal Radiol 2002; 31 (05) 307-310
    CrossrefPubMedGoogle Scholar
  • 46 Heffner Jr RR, Armbrustmacher VW, Earle KM. Focal myositis. Cancer 1977; 40 (01) 301-306
    CrossrefPubMedGoogle Scholar
  • 47 Garrett Jr WE. Muscle strain injuries: clinical and basic aspects. Med Sci Sports Exerc 1990; 22 (04) 436-443
    PubMedGoogle Scholar
  • 48 De Smet AA, Best TM. MR imaging of the distribution and location of acute hamstring injuries in athletes. AJR Am J Roentgenol 2000; 174 (02) 393-399
    CrossrefPubMedGoogle Scholar
  • 49 Guermazi A, Roemer FW, Robinson P, Tol JL, Regatte RR, Crema MD. Imaging of muscle injuries in sports medicine: sports imaging series. Radiology 2017; 282 (03) 646-663
    CrossrefPubMedGoogle Scholar
  • 50 Blankenbaker DG, Tuite MJ. Temporal changes of muscle injury. Semin Musculoskelet Radiol 2010; 14 (02) 176-193
    Article in Thieme ConnectPubMedGoogle Scholar
  • 51 Jelinek JS, Murphey MD, Aboulafia AJ, Dussault RG, Kaplan PA, Snearly WN. Muscle infarction in patients with diabetes mellitus: MR imaging findings. Radiology 1999; 211 (01) 241-247
    CrossrefPubMedGoogle Scholar
  • 52 Kattapuram TM, Suri R, Rosol MS, Rosenberg AE, Kattapuram SV. Idiopathic and diabetic skeletal muscle necrosis: evaluation by magnetic resonance imaging. Skeletal Radiol 2005; 34 (04) 203-209
    CrossrefPubMedGoogle Scholar
  • 53 Huang BK, Monu JU, Doumanian J. Diabetic myopathy: MRI patterns and current trends. AJR Am J Roentgenol 2010; 195 (01) 198-204
    CrossrefPubMedGoogle Scholar
  • 54 Armstrong RB. Mechanisms of exercise-induced delayed onset muscular soreness: a brief review. Med Sci Sports Exerc 1984; 16 (06) 529-538
    PubMedGoogle Scholar
  • 55 Nurenberg P, Giddings CJ, Stray-Gundersen J, Fleckenstein JL, Gonyea WJ, Peshock RM. MR imaging-guided muscle biopsy for correlation of increased signal intensity with ultrastructural change and delayed-onset muscle soreness after exercise. Radiology 1992; 184 (03) 865-869
    CrossrefPubMedGoogle Scholar
  • 56 Lee JC, Mitchell AW, Healy JC. Imaging of muscle injury in the elite athlete. Br J Radiol 2012; 85 (1016): 1173-1185
    CrossrefPubMedGoogle Scholar
  • 57 Hegazi TM, Belair JA, McCarthy EJ, Roedl JB, Morrison WB. Sports injuries about the hip: what the radiologist should know. Radiographics 2016; 36 (06) 1717-1745
    CrossrefPubMedGoogle Scholar
  • 58 Bendszus M, Koltzenburg M, Wessig C, Solymosi L. Sequential MR imaging of denervated muscle: experimental study. AJNR Am J Neuroradiol 2002; 23 (08) 1427-1431
    PubMedGoogle Scholar
  • 59 Sneag DB, Lee SC, Feinberg JH, Melisaratus DP, Amber I. Magnetic resonance imaging patterns of mononeuropathic denervation in muscles with dual innervation. Skeletal Radiol 2017; 46 (12) 1657-1665
    CrossrefPubMedGoogle Scholar
  • 60 Gaskin CM, Helms CA. Parsonage-Turner syndrome: MR imaging findings and clinical information of 27 patients. Radiology 2006; 240 (02) 501-507
    CrossrefPubMedGoogle Scholar
  • 61 Benjamin M. The fascia of the limbs and back—a review. J Anat 2009; 214 (01) 1-18
    CrossrefPubMedGoogle Scholar
  • 62 Baumann F, Brühlmann P, Andreisek G, Michel BA, Marincek B, Weishaupt D. MRI for diagnosis and monitoring of patients with eosinophilic fasciitis. AJR Am J Roentgenol 2005; 184 (01) 169-174
    CrossrefPubMedGoogle Scholar
  • 63 De Clerck LS, Degryse HR, Wouters E. , et al. Magnetic resonance imaging in the evaluation of patients with eosinophilic fasciitis. J Rheumatol 1989; 16 (09) 1270-1273
    PubMedGoogle Scholar
  • 64 Liou CH, Huang GS, Taylor JA, Juan CJ, Gao HW, Chen CY. Eosinophilic fasciitis in a military recruit: MRI evaluation with clinical correlation. Skeletal Radiol 2003; 32 (01) 52-57
    CrossrefPubMedGoogle Scholar
  • 65 Moulton SJ, Kransdorf MJ, Ginsburg WW, Abril A, Persellin S. Eosinophilic fasciitis: spectrum of MRI findings. AJR Am J Roentgenol 2005; 184 (03) 975-978
    CrossrefPubMedGoogle Scholar
  • 66 Paz Maya S, Dualde Beltrán D, Lemercier P, Leiva-Salinas C. Necrotizing fasciitis: an urgent diagnosis. Skeletal Radiol 2014; 43 (05) 577-589
    CrossrefPubMedGoogle Scholar
  • 67 Becker M, Zbären P, Hermans R. , et al. Necrotizing fasciitis of the head and neck: role of CT in diagnosis and management. Radiology 1997; 202 (02) 471-476
    CrossrefPubMedGoogle Scholar
  • 68 Fugitt JB, Puckett ML, Quigley MM, Kerr SM. Necrotizing fasciitis. Radiographics 2004; 24 (05) 1472-1476
    CrossrefPubMedGoogle Scholar
  • 69 Wysoki MG, Santora TA, Shah RM, Friedman AC. Necrotizing fasciitis: CT characteristics. Radiology 1997; 203 (03) 859-863
    CrossrefPubMedGoogle Scholar
  • 70 Chao HC, Kong MS, Lin TY. Diagnosis of necrotizing fasciitis in children. J Ultrasound Med 1999; 18 (04) 277-281
    CrossrefPubMedGoogle Scholar
  • 71 Schmid MR, Kossmann T, Duewell S. Differentiation of necrotizing fasciitis and cellulitis using MR imaging. AJR Am J Roentgenol 1998; 170 (03) 615-620
    CrossrefPubMedGoogle Scholar
  • 72 Kim KT, Kim YJ, Won Lee J. , et al. Can necrotizing infectious fasciitis be differentiated from nonnecrotizing infectious fasciitis with MR imaging?. Radiology 2011; 259 (03) 816-824
    CrossrefPubMedGoogle Scholar
  • 73 Khuu A, Yablon CM, Jacobson JA, Inyang A, Lucas DR, Biermann JS. Nodular fasciitis: characteristic imaging features on sonography and magnetic resonance imaging. J Ultrasound Med 2014; 33 (04) 565-573
    CrossrefPubMedGoogle Scholar
  • 74 Bernstein KE, Lattes R. Nodular (pseudosarcomatous) fasciitis, a nonrecurrent lesion: clinicopathologic study of 134 cases. Cancer 1982; 49 (08) 1668-1678
    CrossrefPubMedGoogle Scholar
  • 75 Coyle J, White LM, Dickson B, Ferguson P, Wunder J, Naraghi A. MRI characteristics of nodular fasciitis of the musculoskeletal system. Skeletal Radiol 2013; 42 (07) 975-982
    CrossrefPubMedGoogle Scholar
  • 76 Erickson-Johnson MR, Chou MM, Evers BR. , et al. Nodular fasciitis: a novel model of transient neoplasia induced by MYH9-USP6 gene fusion. Lab Invest 2011; 91 (10) 1427-1433
    CrossrefPubMedGoogle Scholar
  • 77 Park JS, Park HB, Lee JS, Na JB. Nodular fasciitis with cortical erosion of the hand. Clin Orthop Surg 2012; 4 (01) 98-101
    CrossrefPubMedGoogle Scholar