The role of magnetic resonance imaging techniques in evaluation and management of the idiopathic inflammatory myopathies

Magnetic resonance imaging (MRI) is an important tool in the evaluation of neuromuscular disorders. MRI accurately demonstrates muscle oedema, atrophy, subcutaneous pathology and fatty infiltration and also highlights the distribution of muscle involvement. This review examines the role of MRI in evaluation of the idiopathic inflammatory myopathies (IIMs), a heterogeneous group of autoimmune conditions characterised by muscle inflammation and a variety of extra-muscular manifestations. MRI has a clear role in aiding diagnosis of these conditions, guiding muscle biopsy, differentiating subtypes of IIM using a pattern-based approach, and monitoring disease activity in a longitudinal fashion. Whole body MRI is an emerging technique that offers several advantages over regional MRI, but is not currently widely available. We will also consider newer MRI techniques which provide detailed information regarding the metabolism, function and structure of muscle, although their use is restricted to research purposes at present.