The Inflammatory Myopathies

This book is dedicated to our readers with the intention of providing an informative exposition of the myositis syndromes. It is also presented in the hope that perhaps it may serve to inspire and stimulate discussion and research into these disabling disorders. Included are descriptions of clinical features, differential diagnosis, pathogenetic mechanisms, and approaches to therapy. Current concepts of classi- cation and diagnostic techniques are also presented. The production staff at Humana Springer, especially Ms. F. Louie and Ms. C. Walsh, have been instrumental and invaluable in allowing this work to see the light of day. Above all, the scholarly essays of the contributing authors are acknowledged with gratitude. They have given this volume its character and existence. New York, NY Lawrence J. Kagen v Contents Preface . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . v Contributors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ix 1 Evaluation of the Patient . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 Lawrence J. Kagen 2 Classification of Idiopathic Inflammatory Myopathies . . . . . . . . . . . . . . . . . . . . . . . . 15 Frederick W. Miller 3 The Inflammatory Milieu: Cells and Cytokines. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29 Ann M. Reed and Thomas A. Griffin 4 Juvenile Dermatomyositis: An Update on Clinical and Laboratory Findings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 55 Lauren M. Pachman 5 Inclusion Body Myositis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 87 Lawrence J. Kagen 6 The Role of Muscle Biopsy in the Diagnosis of Inflammatory Myopathy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 95 Sakir Humayun Gultekin 7 Electromyography . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 1 1 Hans L. Carlson 8 Magnetic Resonance Imaging of Myopathies and Myositis . . . . . . . . . . . . . . . . . 127 Carolyn M. Sofka 9 Ultrasound in the Evaluation of the Inflammatory Myopathies . . . . . . . . . 147 Ronald S. Adler and Giovanna Garofalo vii viii Contents 10 Serological Findings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 165 Ira N.