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Rheumatology 2000; 39: 7-17
© 2000 British Society for Rheumatology

Reviews

Treatment and investigation of idiopathic inflammatory myopathies

I. Lundberg and Y.-L. Chung1

Department of Rheumatology, Karolinska Hospital, S-171 76, Sweden and
1 Department of Medicine, King's College School of Medicine and Dentistry, Bessemer Road, Denmark Hill, London SEP 9PJ and Robert Steiner MR Unit, Clinical Research Centre, Medical Research Centre, Imperial College School of Medicine, Hammersmith Hospital Campus, DuCane Road, London W12 0HS, UK

Correspondence to: I. Lundberg, Department of Rheumatology, Karolinska Hospital, S-171 76, Sweden.


   Introduction
 
The idiopathic inflammatory myopathies (IIM) are systemic connective tissue diseases which are characterized by symmetrical, proximal muscle weakness, decreased muscle endurance and chronic inflammation in muscle tissue [1–3]. They can be subclassified into dermatomyositis, polymyositis and inclusion body myositis (IBM) according to differences in clinical as well as histopathological features [1, 4]. Dermatomyositis may occur in both adults and children; in this review, we will, however, focus on the treatment of adult forms of myositis only. Myositis may exist as a disease entity on its own or may be linked to another inflammatory connective tissue disease such as systemic sclerosis or mixed connective tissue disease. Myositis may also be associated with a malignancy, this is particularly true for dermatomyositis, but the association with polymyositis is more controversial [1]. The IIM are chronic disorders in most cases and up to two-thirds of . . . [Full Text of this Article]


   The pathophysiological basis for treatment of IIM
 

   Pharmacological therapy
 
Corticosteroids
Other immunosuppressive treatment

   Non-pharmacological therapy
 

   Investigations for assessment of treatment
 

   Functional assessment
 

   Laboratory investigations
 
Muscle biopsy
Magnetic resonance imaging
Phosphorus magnetic resonance spectroscopy
Proton magnetic resonance spectroscopy
Ultrasound

   Summary
 

   Acknowledgments
 

   References
 

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