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[MRI of musculature in myalgia--indications and image findings].
[focal myositis]
This
paper
deals
with
the
question
of
the
clinical
circumstances
in
which
MRI
seems
to
be
promising
in
patients
with
myalgia
.
241
patients
suffering
from
myalgic
symptoms
were
examined
by
axial
scans
of
the
muscular
system
with
T
1
w
and
STIR-sequences
.
All
patients
underwent
a
complete
neuromuscular
examination
,
which
included
an
MRI
guided
muscle
-biopsy
of
203
patients
.
The
images
were
retrospectively
analysed
as
to
the
typical
characteristics
of
differential
diagnosis
.
In
cases
of
idiopathic
or
bacterial
/
viral
induced
myositis
,
primary
vasculitis
,
and
rhabdomyolysis
,
edematous
changes
of
the
muscles
could
always
be
found
.
Abscesses
were
only
found
in
bacterial
myositis
.
In
cases
of
poly-
and
dermatomyositis
as
well
as
inclusion-body-
myositis
,
MRI
showed
a
uniform
distribution
pattern
with
emphasis
on
the
quadriceps
muscles
.
In
contrast
to
other
neuromuscular
diseases
in
bacterial
induced
myositis
,
focal
myositis
,
and
rhabdomyolysis
a
strong
contrast
agent
enhancement
was
seen
.
All
patients
with
myalgic
syndromes
without
any
other
additional
neuropathological
findings
and
86
%
of
the
patients
suffering
from
polymyalgia
rheumatica
had
normal
MR-findings
.
MRI
allows
a
correct
exclusion
of
an
inflammatory
,
tumorous
,
or
rhabdomyolitic
cause
of
a
myalgia
and
leads
to
pathognomonic
findings
for
these
diseases
.
Diseases
belonging
to
the
group
of
endocrine
,
toxic
,
or
metabolic
myopathies
might
be
normal
in
MRI
.
We
believe
that
an
indication
for
MRI
is
given
when
muscular
pain
is
associated
with
additional
neuromuscular
symptoms
,
especially
if
an
inflammatory
origin
of
the
myalgia
is
suspected
or
if
a
muscle
biopsy
is
planned
.
Diseases
Validation
Diseases presenting
"edematous changes of the muscles could always be found"
symptom
focal myositis
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