Abstract
Myositis is a systemic autoimmune disease frequently affecting the muscle, skin, joints, lungs, and vascular, gastrointestinal, and cardiac organ systems. The evaluation of a patient with a suspected diagnosis of myositis begins with a comprehensive history and physical examination of all organ systems as well as the consideration of other possible diagnoses. Demographics as well as the onset, distribution, pattern, and progression of muscle symptoms can provide important diagnostic clues. Laboratory, imaging, and electromyography studies will narrow the differential diagnosis, but in most cases, a muscle biopsy is necessary to confirm the diagnosis. The need for a muscle biopsy may be unnecessary in classic presentations of the anti-synthetase syndrome and in patients with clinically amyopathic dermatomyositis, where skin biopsy may be required. Polymyositis (PM) is often misdiagnosed or overdiagnosed as many other muscular disorders including inclusion body myositis, muscular dystrophies, and metabolic myopathies can mimic PM. In this chapter, we discuss the art and science of making a diagnosis of myositis from the history to a confirmatory muscle biopsy, as well as important pitfalls in evaluating myositis.
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Aggarwal, R., Oddis, C.V. (2020). Evaluating the Patient with Suspected Myositis. In: Aggarwal, R., Oddis, C. (eds) Managing Myositis. Springer, Cham. https://doi.org/10.1007/978-3-030-15820-0_3
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DOI: https://doi.org/10.1007/978-3-030-15820-0_3
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