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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
"rhabdomyolysis"
symptom
adrenomyeloneuropathy
dystrophic epidermolysis bullosa
focal myositis
inclusion body myositis
pyomyositis
pyruvate dehydrogenase deficiency
scrub typhus
systemic capillary leak syndrome
This symptom has already been validated