title: Whole-body muscle MRI to detect myopathies in non-extrapyramidal bent spine syndrome.
abstract: OBJECTIVE
  Bent spine syndrome (BSS), defined as an abnormal forward flexion of the trunk resolving in supine position, is usually related to parkinsonism, but can also be encountered in myopathies. This study evaluates whole-body muscle MRI (WB-mMRI) as a tool for detecting underlying myopathy in non-extrapyramidal BSS.
  
  
  METHODS
  Forty-three patients (90 % women; 53-86 years old) with a non-extrapyramidal BSS were prospectively included. All underwent a 1.5-T WB-mMRI and a nerve conduction study. Muscle biopsy was performed if a myopathy could not be eliminated based on clinical examination and all tests. Systematic MRI interpretation focused on peripheral and axial muscle injury; spinal posture and incidental findings were also reported.
  
  
  RESULTS
  WB-mMRI was completed for all patients, with 13 muscle biopsies ultimately needed and myopathy revealed as the final etiological diagnosis in five cases (12 %). All biopsy-proven myopathies were detected by the WB-mMRI. Relevant incidental MRI findings were made in seven patients.
  
  
  CONCLUSIONS
  This study supports WB-mMRI as a sensitive and feasible tool for detecting myopathy in BSS patients. Associated with electroneuromyography, it can better indicate when a muscle biopsy is needed and guide it when required. Rigorous radiological interpretation is mandatory, so as not to miss incidental findings of clinical consequence.
authors.affiliation: Service de Radiologie B, Nouvel Hôpital Civil - Hôpitaux Universitaires de Strasbourg, 1 place de l'hôpital, 67000, Strasbourg, France, mickael.ohana@gmail.com.
authors.forename: Mickaël
authors.initials: M
authors.lastname: Ohana
authors.forename: Marie-Christine
authors.initials: MC
authors.lastname: Durand
authors.forename: Catherine
authors.initials: C
authors.lastname: Marty
authors.forename: Jean-Philippe
authors.initials: JP
authors.lastname: Lazareth
authors.forename: Thierry
authors.initials: T
authors.lastname: Maisonobe
authors.forename: Dominique
authors.initials: D
authors.lastname: Mompoint
authors.forename: Robert-Yves
authors.initials: RY
authors.lastname: Carlier
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy / Q000379:methods; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000473:pathology*; D009134:Muscular Atrophy, Spinal / Q000150:complications* / Q000473:pathology; D009135:Muscular Diseases / Q000150:complications* / Q000175:diagnosis* / Q000473:pathology; D015588:Observer Variation; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D013121:Spinal Curvatures / Q000150:complications* / Q000473:pathology; D051598:Whole Body Imaging / Q000379:methods*