title: Whole-body MRI for full assessment and characterization of diffuse inflammatory myopathy.
abstract: BACKGROUND
  Conventional magnetic resonance imaging (MRI) is a highly valuable tool for full assessment of the extent of bilateral symmetrical diffuse inflammatory myopathy, owing to its high sensitivity in the detection of edema which correlates with, and sometimes precedes, clinical findings.
  
  
  OBJECTIVE
  To evaluate the use of whole-body (WB)-MRI in characterization and full assessment of the extent and distribution of diffuse inflammatory myopathy.
  
  
  METHODS
  A prospective study on 15 patients presenting with clinical evidence of inflammatory myopathy. It included 4 boys/men and 11 girls/women (age range, 6-44 years; mean age, 25.5 years). 1.5 T WB-MRI was performed and the distribution and extent of disease severity was assessed according to muscle edema on STIR images.
  
  
  RESULTS
  Four cases of dermatomyositis showed lower limb disease predilection with edema in gluteal, thigh, and calf muscles. The same finding was seen in one case with recurrent polymyositis and three cases with overlap myositis with systemic lupus erythematosus (SLE). Bilateral upper and lower limb myositis was demonstrated in three cases of polymyositis and one case of overlap myositis with scleroderma. Bilateral edema involving all scanned muscle groups was detected in three cases of polymyositis with paraneoplastic syndrome, SLE, and severe active dermatomyositis (including the neck muscles).
  
  
  CONCLUSIONS
  WB-MRI is the diagnostic modality of choice for cases of inflammatory myopathy. It accurately detects the most severely affected muscles candidate for biopsy and provides a reliable baseline study for follow-up of disease progression as well as response to treatment.
authors.affiliation: Radiodiagnosis Department, Mansoura Faculty of Medicine, Mansoura University, Mansoura, Egypt.
authors.forename: Saleh Saleh
authors.initials: SS
authors.lastname: Elessawy
authors.affiliation: Radiodiagnosis Department, Mansoura Faculty of Medicine, Mansoura University, Mansoura, Egypt.
authors.forename: Eman Muhammad
authors.initials: EM
authors.lastname: Abdelsalam
authors.affiliation: Physical Medicine, Rheumatology and Rehabilitation Department, Mansoura Faculty of Medicine, Mansoura University, Mansoura, Egypt.
authors.forename: Eman
authors.initials: E
authors.lastname: Abdel Razek
authors.affiliation: Internal Medicine Department, Rheumatology and Immunology Unit, Mansoura Faculty of Medicine, Mansoura University, Mansoura, Egypt.
authors.forename: Samar
authors.initials: S
authors.lastname: Tharwat
keywords: Polymyositis; dermatomyositis; magnetic resonance imaging (MRI); systemic lupus erythematosus; whole body MRI