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Myositis is a type of myopathy, or disease, that causes inflammation in the muscles, leading to muscle weakness, swelling, and pain. It can affect different muscle groups throughout the body, including the arms, shoulders, legs, hips, abdomen, spine, neck, back, wrists, fingers, and thighs. While the exact cause of myositis is unknown, it is believed to be triggered by infection, injury, autoimmune conditions, or drug side effects. Diagnosis of myositis involves a physical examination and tests such as blood tests, MRI, EMG, and muscle biopsy. Treatment options include corticosteroids, immunosuppressants, and intravenous immunoglobulin, along with exercises to improve muscle strength and flexibility.
| Characteristics | Values |
|---|---|
| Type | Myopathy, a disease that attacks and weakens muscle fibres |
| Cause | Unclear, but could be triggered by infection, injury, autoimmune conditions, or drug side effects |
| Symptoms | Muscle weakness, pain, swelling, trouble breathing or swallowing, arrhythmia |
| Diagnosis | Physical exam, blood tests, MRI, EMG, muscle biopsy |
| Treatment | Corticosteroids, immunosuppressants, intravenous immunoglobulin, exercises, speech therapy |
| Prognosis | No cure, but treatments can ease symptoms; can be disabling over time |
| Prevention | N/A |
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What You'll Learn
Myositis diagnosis
Myositis is a type of myopathy, which refers to diseases that affect the muscles connected to bones (skeletal muscles). Myositis causes inflammation in the muscles, leading to weakness, swelling, and pain, making everyday activities difficult. It can be caused by a viral infection, alcohol, certain medications, or an autoimmune disease. The diagnosis of myositis typically involves a comprehensive physical examination, blood tests, and in some cases, electromyography (EMG) or a muscle biopsy.
During the physical exam, a doctor will assess muscle weakness through simple movements and motions. They may also perform a neurological test to evaluate electrical activity in the muscles. Blood tests are used to detect high levels of muscle enzymes, which indicate muscle breakdown and damage. In addition, specific blood tests can identify autoantibodies associated with inflammatory myopathies. Electromyography (EMG) is a test that assesses the electrical activity of muscles and can be useful in diagnosing myositis.
A muscle biopsy, considered the most definitive test, involves removing a small sample of muscle tissue to examine abnormalities, including inflammation, damage, and abnormal proteins. Skin biopsies may also be performed for patients with skin symptoms to look for characteristic abnormalities. Magnetic resonance imaging (MRI) can also be used to aid in diagnosis.
Myositis can manifest in several forms, including polymyositis, dermatomyositis, and inclusion body myositis. Polymyositis affects multiple muscles simultaneously, causing symptoms in the muscles near the body's centre. It typically affects adults, especially females, and develops gradually over time. Dermatomyositis affects both the skin and muscles and can develop quickly or take months. It is often associated with a rash on the eyelids, neck, shoulders, upper chest, or knuckles. Inclusion body myositis (IBM) is a degenerative disease that weakens the muscles over time, usually starting in the limbs.
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Myositis treatment
Myositis is a group of rare conditions that cause muscle inflammation and weakness. It is an autoimmune disease, where the immune system attacks the body's muscles and tissues, causing muscle weakness and other related conditions. The main symptom of myositis is muscle weakness, which can start very gradually and cause difficulty in performing everyday activities. It can also cause swelling and pain.
There is currently no cure for myositis. However, treatment can help control the symptoms and reduce inflammation. The best treatment for myositis depends on what is causing it. Treatment options include:
- Medicines: Corticosteroids, immunosuppressants, and immunoglobulin therapy are used to slow down the attack on healthy tissue and improve skin rashes. Nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin or ibuprofen can also be used for pain relief.
- Exercise: Stretches and exercises can help keep the affected muscles flexible and strong, reducing pain and stiffness. Supervised exercises are recommended to be combined with pharmacological treatment.
- Nutrition: A trained nutritionist can help design a diet that is right for the patient's lifestyle and overall health.
- Stress reduction: Doctors may suggest exercises like yoga or biofeedback exercises to help patients find an outlet for daily stress.
The type of myositis is diagnosed based on the patient's symptoms and the location of the affected muscles. The different forms of myositis include polymyositis, dermatomyositis, inclusion body myositis, and necrotizing autoimmune myopathy. Polymyositis affects multiple muscles simultaneously and causes symptoms in muscles near the center of the body. Dermatomyositis affects the skin in addition to the muscles. Inclusion body myositis is a degenerative disease that slowly weakens the muscles, usually starting in the limbs. Necrotizing autoimmune myopathy is a rare condition where muscle cells start to die, leading to muscle weakness.
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Myositis symptoms
Myositis is a group of rare conditions that cause inflammation and weakness in the muscles that connect to bones (skeletal muscles). It can also refer to the muscle inflammation itself. Different forms of myositis affect different muscle groups in the body. The main symptom of myositis is muscle weakness, which can start very gradually and cause difficulty in performing everyday activities. It can also cause muscle pain and swelling.
The symptoms of myositis vary between individuals. The most commonly affected muscles are around the shoulders, hips, and thighs. Weakness and tiredness in the muscles can make people with myositis more prone to falling. The weakening of muscles can also cause difficulty in gripping objects and perform everyday tasks such as climbing stairs, brushing hair, and getting in and out of cars. In some cases, myositis can cause trouble breathing or swallowing, arrhythmia (if it affects the heart), and a loss of control over arms, hands, or legs.
The two most common types of myositis are polymyositis and dermatomyositis. Polymyositis affects multiple muscles simultaneously, often those near the center of the body, and causes difficulty in performing movements such as standing up after sitting, climbing stairs, lifting objects, or reaching overhead. Dermatomyositis causes similar symptoms but also affects the skin, causing a red or pink rash on the upper eyelids, face, neck, and the backs of the hands and fingers. This rash can be itchy and may also affect the scalp, chest, and hands.
Inclusion body myositis (IBM) is a degenerative disease that slowly weakens muscles over time, usually starting in the limbs. IBM usually isn't painful but can cause difficulty in gripping objects and may lead to frequent tripping or falling. Sporadic IBM usually begins after the age of 50 and worsens over time.
There is no cure for myositis, but treatments can help manage the symptoms and reduce their impact on daily life. Treatments include medications such as corticosteroids, immunosuppressants, and intravenous immunoglobulin, along with recommended exercises and stretches to improve muscle strength and flexibility.
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Myositis risk factors
Myositis is an uncommon disorder characterised by inflammation of the muscles used for movement. It is a type of myopathy, which is a general term for diseases that affect the muscles connected to bones. Myositis can cause problems with voluntary movements, ranging from stiffness to weakness, and can be mild, moderate, or severe. While anyone can get myositis, there are several risk factors associated with the disease, including age, sex, and ethnicity.
Age
Myositis is most commonly observed in middle-aged people, with a peak incidence of idiopathic inflammatory myopathies occurring in individuals between the ages of 45 and 64. The occurrence rate in this age group is approximately 8 to 10 new cases per 100,000 people per year. In contrast, younger adults aged 25 to 44 and older adults aged 65 and above have a lower incidence rate of about 3 to 5 new cases per 100,000 people per year.
Sex
Females are at a higher risk of developing certain types of myositis, such as polymyositis, dermatomyositis, and juvenile myositis. Polymyositis, for instance, affects females twice as often as males. However, other forms of myositis, like inclusion body myositis, are more prevalent in men.
Ethnicity
People with Sub-Saharan African descent have a significantly higher risk of developing myositis. They are approximately three times more likely to be affected by the disease compared to individuals with little or no Sub-Saharan African ancestry.
Genetic Factors
Genetic factors also play a role in the risk of developing myositis. Certain genes, including STAT4, TRAF6, UBE2L3, PLCL1, BLK, and CCR5, have been implicated in myositis through their association with specific subtypes of the disease. For example, the presence of HLA-DRB1*03:01 along with C4A deficiency has been identified as the strongest risk factor for juvenile dermatomyositis.
Environmental Factors
In addition to genetic factors, environmental exposures can also influence the risk of myositis. However, the specific environmental triggers are not always clear. Viral infections are the most common infectious cause of myositis, but bacterial, fungal, or other organisms can also be responsible. Additionally, certain medications and drugs can cause temporary muscle damage and myositis-like symptoms.
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Types of myositis
Myositis is a group of conditions that cause inflammation in muscles, leading to weakness, swelling, and pain. It is an autoimmune disease, where the immune system attacks its own tissue, causing inflammation and weakening the muscles. There are several types of myositis, each affecting the muscles differently. Here are some of the most common types:
Polymyositis
Polymyositis affects multiple muscles simultaneously, usually those closest to the body's core, such as the neck, hips, back, and shoulders. It causes muscle weakness that worsens over time and can make it difficult to perform everyday movements such as standing up after sitting, climbing stairs, or lifting objects. Polymyositis typically affects adults and is more common in women.
Dermatomyositis
Dermatomyositis affects the muscles and the skin. It causes muscle weakness and a distinctive rash on the eyelids, cheeks, nose, back, upper chest, elbows, knees, and/or knuckles. Dermatomyositis can develop quickly or slowly over several months. It affects people of all ages and sexes but is more prevalent in women and, recently, in African-American women.
Sporadic Inclusion Body Myositis (sIBM)
Inclusion body myositis (IBM) is the most common form of myositis in people over 50. It is a degenerative disease that slowly weakens the muscles, usually starting in the limbs. sIBM can cause difficulty in gripping objects, walking, and may increase the risk of falling or tripping. It is usually not painful.
Necrotizing Myopathy
Necrotizing myopathy, also known as necrotizing autoimmune myopathy (NAM) or immune-mediated necrotizing myopathy (IMNM), is a recently defined form of myositis. It is characterised by muscle cell death (necrosis) and subsequent muscle weakness. This type of myositis does not usually cause significant inflammation.
Juvenile Myositis (JM)
Juvenile myositis refers to any version of myositis found in children under the age of 18. It is characterised by muscle weakness in the neck, shoulders, back, and torso, along with a red, patchy skin rash.
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Frequently asked questions
Myositis is a type of myopathy, which is a general term for diseases that affect the muscles connected to bones (skeletal muscles). It causes inflammation in the muscles, leading to weakness, swelling, and pain, making everyday activities difficult.
Myositis usually affects the muscles used for movement, including those in the arms, shoulders, legs, hips, abdomen, spine, neck, back, wrists, fingers, and thighs. Different forms of myositis affect different groups of muscles. For example, polymyositis affects multiple muscles simultaneously, especially those near the center of the body, while inclusion body myositis starts in the limbs.
There is currently no cure for myositis, but treatments can help manage symptoms and reduce their impact on daily life. Treatments include corticosteroids, immunosuppressants, intravenous immunoglobulin, and physical therapy. Exercises like stretching can help strengthen affected muscles and reduce pain and stiffness.
