Myositis Guide: Causes, Symptoms and Treatment Options Myositis What Is It? Myositis is the medical term for muscle inflammation. In myositis, inflammation damages the fibers of a muscle. This causes muscles to be weak by interfering with the ability of the muscles to contract. Although myositis can cause muscle aches and muscle tenderness, weakness is usually the dominant symptom. In some cases, myositis is a short-term problem that goes away after a few days or weeks. In other cases, it is part of a chronic (long-term) condition. Chronic forms of myositis can lead to muscle atrophy (wasting and shrinking) and severe disability. There are many different types of myositis, including: Idiopathic inflammatory myopathies. In this rare group of muscle diseases, the cause of the muscle inflammation is unknown (idiopathic). There are three major types: dermatomyositis, polymyositis and inclusion body myositis. In the United States, idiopathic inflammatory myopathies affect about 1 out of every 100,000 people.

Polymyositis and dermatomyositis are most common in women, whereas inclusion body myositis affects men more often. Symptoms can start at any age, but the average age of first symptoms is a bit younger in dermatomyositis and polymyositis (age 50) than in inclusion body myositis (age 60). So far, most of the evidence suggests that polymyositis and dermatomyositis are autoimmune disorders, illnesses in which the immune system mistakenly attacks the body's own tissues. The muscles of people with inclusion body myositis contain an abnormal protein called amyloid, but the reason it forms is unknown. This amyloid protein is similar to the protein deposited in the brains of people with Alzheimer's disease, and some experts believe that the two diseases may develop the same way. In inclusion body myositis, the muscle also contains tiny structures that resemble viral particles (called inclusion bodies), although no viral infection has been consistently identified in association with this disease. In dermatomyositis, cancer is found in approximately 10% to 20% of cases. Sometimes, the muscle problem develops first. In other cases, the cancer is detected before the myositis.

Myositis that is otherwise quite similar to polymyositis or dermatomyositis may accompany other autoimmune disease such as systemic lupus erythematosus (SLE) or progressive systemic sclerosis (also called scleroderma). Infectious myositis. Myositis sometimes occurs as part of a systemic (whole body) infection, especially a viral infection. It is especially common among people who have the flu (influenza). Myositis also can be caused by trichinosis, an infection in which tiny parasites invade the muscles. People can develop this infection by eating meat that has not been cooked enough. One type of infectious myositis is called pyomyositis, a bacterial infection that causes one or more pockets of pus (abscesses) inside a muscle. It usually is caused by Staphylococcus ("staph") bacteria. Pyomyositis is a relatively common infection in developing countries in tropical climates, especially where sanitation and health care are poor. However, it sometimes occurs in the United States, primarily in people who inject illegal drugs and in people infected with HIV. Benign acute myositis. In benign acute myositis, a young child suddenly develops severe leg pain and cannot walk normally.

These symptoms are dramatic and frightening, but they usually disappear within a few days. Benign acute myositis usually occurs in children who are recovering from the flu or some other respiratory infection caused by a virus. Doctors are not sure whether the child's muscle symptoms are caused by the virus itself or by the body's immune reaction to the virus. Myositis ossificans. In myositis ossificans, a lump of bony material forms inside a muscle. This usually happens after a muscle injury, especially a deep bruise. Drug-induced myositis. In drug-induced myositis, muscle inflammation occurs as a side effect of a medication or a combination of medicines. Although this is rare, the most common medications that can cause myositis are the cholesterol-lowering drugs called statins, including atorvastatin ( Lipitor ), lovastatin ( Mevacor ) and simvastatin ( Zocor ) and zidovudine ( Retrovir ), also called AZT, a drug used to treat HIV/AIDS. Symptoms Symptoms of myositis can include muscle weakness, muscle pain and muscle tenderness. Other symptoms vary, depending on the specific cause of myositis: Idiopathic inflammatory myopathies.

These conditions typically cause painless muscle weakness that develops slowly over weeks, months or years. Although up to 40% of people with 1 of these conditions have muscle pain, the weakness is usually worse than the pain. In polymyositis and dermatomyositis, weakness usually affects the muscles near the center of the body (called proximal muscles), including the muscles of the neck, shoulders and hips causing difficult with lifting, reaching over the head, or arising from a chair. Some patients also have difficulty swallowing. In dermatomyositis, skin symptoms accompany muscle problems. These can include purple discoloration of the eyelids, a red rash on the face and neck, or scaly patches, usually on the knuckles. In inclusion body myositis, weakness typically starts in the upper legs and later affects the upper arms and muscles farther away from the center of the body (called distal muscles), including muscles of the hand and wrist and lower legs. Muscle wasting (atrophy) is often prominent. Up to one-half of these patients have trouble swallowing. Infectious myositis.

When infectious myositis is caused by the flu, symptoms include not only muscle aches and muscle weakness, but also high fever, chills, sore throat, cough, fatigue and runny nose. When caused by trichinosis, symptoms in the early stages include diarrhea and vomiting. Later, as the parasites invade the muscles, symptoms can include fever, eye redness with swelling in the lids and muscle pain. Patients with pyomyositis usually have a fever, and the abscessed muscle is painful, tender and slightly swollen. Skin over the muscle may be red and hot. Benign acute myositis. A child suddenly has trouble walking and complains of severe leg pain. This pain is often worst in the calf muscles. In most cases, the child also has a history of recent fever, runny nose, sore throat and other upper respiratory symptoms. Myositis ossificans. A lump appears in the affected muscle, and this lump may hurt when you press it. These symptoms usually begin several weeks after a muscle injury, especially a bruise. Drug-induced myositis. Symptoms include muscle soreness, pain and weakness. These symptoms usually begin soon after a person starts taking a new drug or a combination of drugs.

Myositis is more common when a person is taking a combination of lipid-lowering medications, such as gemfibrozil ( Lopid ) and lovastatin (Mevacor), than when a single medication is used. Diagnosis Your doctor will ask you to describe your symptoms. It is especially important to describe the exact location of any weakness or muscle pain and how long you have had it. The doctor also will review your medical history and current medications. Next, your doctor will examine you, paying special attention to your muscles and nerves. Depending on what your doctor finds, he or she may order diagnostic tests.

Common tests used to diagnose muscle problems include: Blood tests to measure levels of muscle enzymes, auto-antibodies (antibodies directed against one's own cells or organs) and antibodies to infectious agents An electromyogram, a test that measures the electrical activity of muscles Magnetic resonance imaging (MRI), a painless scan that can identify abnormal muscle and can be used to locate the best site for a biopsy to establish the diagnosis or to monitor the progress of a known type of myositis A standard X-ray or a bone scan if your doctor suspects you have myositis ossificans An ultrasound, computed tomography (CT) scan or MRI if pyomyositis is suspected A muscle biopsy. With this test, the doctor takes a sample of muscle tissue to be checked under the microscope. Muscle biopsy is the best way to establish the diagnosis of myositis; it may be diagnostic if it shows clear muscle inflammation. However, the results are not always abnormal even in people who have myositis. Expected Duration How long myositis lasts varies depending on the cause: Idiopathic inflammatory myopathies. Polymyositis and dermatomyositis are usually chronic (long-lasting) but typically improve after one to two months of treatment.

Inclusion body myositis is also chronic. Since there is no reliably effective treatment for inclusion body myositis, symptoms usually worsen gradually over a period of years. If cancer is associated with the myositis, improvement may occur if the cancer is treated effectively. Infectious myositis. Flu symptoms usually last three to seven days. In trichinosis, symptoms peak in about three weeks, and then gradually subside. For pyomyositis, your doctor will drain the abscess and you will be given antibiotics. Once the infection is gone, healing can start. Recovery can take weeks or even months in people with chronic illnesses. Benign acute myositis. Patients usually recover within three to seven days. Myositis ossificans. In some cases, the bony lump disappears on its own. However, this can take a few months. If the lump does not go away, it may remain indefinitely or your doctor can remove it surgically. Drug-induced myositis. Symptoms usually disappear once you stop taking the drug. However, this can take weeks or months. Prevention Scientists do not know the cause of most forms of myositis.

For this reason, there are no official guidelines for preventing myositis. Only infectious myositis and drug-induced myositis are potentially preventable. To help prevent these illnesses: Get a flu shot each year. Thoroughly cook pork and other meats. Never inject illegal drugs under your skin or into your muscles. With prescription drugs that are injected, the injection site should be as clean as possible. Keep your skin clean. Take the lowest number and lowest doses of medications that are necessary. Routine blood tests to look for drug-induced muscle injury may be helpful as well. Treatment Treatment varies, depending on the type of myositis. Idiopathic inflammatory myopathies. For polymyositis and dermatomyositis, doctors usually begin treatment with a corticosteroid drug, such as prednisone (sold as a generic) or methylprednisolone ( Solu-Medrol , others). If this fails, methotrexate ( Rheumatrex ) or azathioprine ( Imuran ) may be added. Intravenous immunoglobulin (an injection of antibodies collected from blood donors) may be effective in cases that fail these other treatments.

Other immunosuppressant medications may be recommended to treat dermatomyositis and polymyositis, including cyclosporine , rituximab , mycophenolate mofetil or cyclophosphamide . Unfortunately, there is no reliably effective treatment for inclusion body myositis, although corticosteroid treatment and immunosuppressive therapies (as with polymyositis and dermatomyositis) are often tried for at least several months. If treatment is effective, ongoing therapy may improve strength or prevent worsening weakness. When myositis accompanies another autoimmune disease (such as SLE), treatment of the underlying disease may be helpful; otherwise, treatment of the myositis is similar to that of polymyositis and dermatomyositis. Infectious myositis. If you have the flu, you should rest in bed and drink plenty of fluids. You also can take nonprescription medicines for fever and muscle aches. If you have trichinosis, your doctor may treat you with mebendazole ( Vermox ) or albendazole ( Albenza ), antibiotic drugs that kill the trichinosis parasites. In addition, you should rest and take nonprescription drugs for pain.

Your doctor may also prescribe prednisone to reduce inflammation associated with the infection. For pyomyositis, your doctor may recommend drainage of the abscess by making an incision or by inserting a needle. In addition, he or she will prescribe antibiotics to fight the infection. Benign acute myositis. Your child's doctor will prescribe medication for pain. No other treatment is necessary, because the illness usually gets much better within a few days. Myositis ossificans. Your doctor may wait to see whether the bony lump disappears on its own. If it doesn't, he or she may recommend surgery to remove the lump. Drug-induced myositis. Your doctor will discontinue any medication thought to be causing myositis. Medications called corticosteroids may help you to recover faster.

When To Call a Professional Make an appointment to see your doctor if you have: Muscle weakness that doesn't go away A red or purple rash on your face that doesn't go away or scaly patches on your knuckles Muscle aches that don't go away with rest and nonprescription pain medication A lump in any muscle, especially if you also have a fever or other symptoms Muscle pain and weakness that begin after you start taking a new medication Call your doctor immediately if: You have a fever together with muscle pain and weakness You have a muscle that becomes hot, painful, swollen and stiff Your child complains of severe leg pain and has trouble walking Prognosis The outlook varies, depending on the type of myositis. Idiopathic inflammatory myopathies. With proper treatment, most people with polymyositis or dermatomyositis eventually regain at least some muscle strength. Often, muscle strength returns to normal. Typically, inclusion body myositis does not improve with treatment. However, the illness usually progresses slowly and does not affect a person's lifespan unless complications lead to serious illness, such as pneumonia caused by swallowing or breathing problems. Eventually, some patients need a cane to help them walk. Others require a wheelchair.

If a person with dermatomyositis develops cancer, the prognosis may be worse. Medications taken to treat these muscle diseases may cause complications that affect prognosis. For example, serious infections may complicate the use of immune suppressing medications. Infectious myositis. Once the flu passes, muscle symptoms improve. Treatment usually is effective, although recovery can be slow in people with trichinosis. For pyomyositis, the prognosis is good if the infection is treated promptly. If not, the infection can pass into the bloodstream and spread throughout the body. Benign acute myositis. Children typically walk normally again within a few days. Myositis ossificans. The prognosis is very good. If the bony lump does not disappear on its own, your doctor may recommend surgery to remove it. Drug-induced myositis. The prognosis is very good. In most cases, symptoms subside when the drug is stopped.

External resources National Institute of Arthritis and Musculoskeletal and Skin Diseases Information Clearinghouse Myositis | UW Orthopaedics and Sports Medicine, Seattle UW Orthopaedics and Sports Medicine, Seattle Make a Clinic Appointment: (206)520-5000 or Toll Free (877)520-5000 Make a Gift Myositis For up-to-date and comprehensive resources on shoulder arthritis, please visit our new online Shoulder Arthritis Book and Rotator Cuff Tear Book ! Overview Basics of myositis Myositis is the term for illnesses that involve chronic muscle inflammation ("myo" means muscle and "itis" means inflammation). "Myositis" refers to several different illnesses including polymyositis, dermatomyositis and inclusion body myositis. All forms of myositis involve chronic or persistent muscle inflammation. This muscle inflammation almost always results in weakness and less often in heat swelling and pain of the muscles. Myositis can affect many parts of the body. Sometimes the joints heart lungs intestines and skin can become inflamed.

Some forms of myositis like dermatomyositis ("dermato" refers to the skin) result in particular rashes over the knuckles around the eyes or sometimes in other parts of the body. Other forms of myositis occur in children. Some forms are seen with other connective tissues diseases like lupus or rheumatoid arthritis . Still other forms may occur in people with tumors. Rarely myositis can occur in a single part of the body such as one arm, one leg or just the muscles that move the eye. Prognosis Like other rheumatic diseases, myositis is unlikely to go away on its own. But with proper treatment and management these chronic diseases can be brought under control. Curability At present there is no cure for myositis. A person with myositis will need to manage the condition and to adjust to the changes it brings. This may involve continuing to take medicine and seeing a doctor regularly. It may also require changing some activities especially during periods of increased pain and weakness. For most people with myositis however treatment of myositis is satisfactory and they can lead productive lives.

Myositis is more serious if it affects the breathing muscles the heart is combined with a tumor or if certain autoantibodies are present. People with these complications will need to be monitored even more closely by their doctors. Incidence Myositis is a rare disease. In the United States it is estimated that each year five to 10 out of every one million people get one of the forms of myositis. Although myositis can affect people of any age most children who get the disease are between five and 15 years of age and most adults are between 30 and 60. Like many other inflammatory diseases most forms of myositis attack more women than men. The exception is inclusion body myositis a form of myositis in which holes called inclusion bodies develop in the muscle fibers. This form affects more men than women. Symptoms We do not know what causes myositis. But because myositis has many forms it probably has many causes. Some scientists think that myositis results when a person with a certain genetic background is exposed to particular chemicals viruses or other infectious agents. Whatever triggers these diseases also results in abnormalities in the immune system.

The immune system consists of groups of cells called lymphocytes that circulate throughout the body. In healthy people these lymphocytes act as a defense force that produces substances that attack viruses bacteria and other agents of disease. But in many people with myositis there is an abnormality in the immune system that results in the production of proteins called autoantibodies. Autoantibodies and some of the lymphocytes turn against the body's own tissues and may cause damage. Because illnesses associated with autoantibodies are called autoimmune diseases many doctors consider myositis to be an autoimmune disease. Some autoantibodies found in people with myositis are found in other autoimmune diseases but a few special ones are only found in people with myositis. These are called myositis-specific autoantibodies. They seem to be useful in helping doctors predict the problems that some people might develop and how they might respond to treatment. Diagnosis Because myositis closely resembles many other diseases and differs so much from person to person it can be difficult to diagnose. Your doctor may have to perform many tests and see you many times before deciding on a diagnosis of myositis. It often is necessary for your primary care doctor to send you to an arthritis specialist.

Consultation with a neurologist who specializes in disorders of the nervous system may also be indicated. During the process of reaching a diagnosis your doctor will ask a series of questions about the problems you are experiencing and will perform a physical examination. There are blood tests that may be done including some for autoantibodies and muscle enzymes. One of the most useful is a blood test for a muscle enzyme called creatine kinase or CK. In most people with active myositis the CK level in the blood is abnormally high. The CK level tends to go up with increasing myositis disease activity and tends to go down as the myositis improves. Another procedure very useful in diagnosing myositis is an electromyogram (EMG). An EMG measures the electrical pattern of the muscles just as an electrocardiogram (EKG) measures the electrical pattern of the heart. Your doctor will probably also request that a muscle biopsy be done. This is the removal of a small piece of muscle for staining and examination with a microscope. The muscle biopsy shows your doctor whether and how the muscle fibers are damaged. Treatment There are many forms of treatment for myositis but most include medications, exercise physical therapy and rest.

The treatment will vary from person to person and will change over time in a single person. The specific therapy recommended by your doctor will depend upon the severity and type of problems the presence of other medical conditions and adverse reactions to previous therapy. Exercise and therapy A physical therapy or exercise program is an important part of treating myositis and can help improve muscle strength. However you should not begin vigorous exercise until the drug treatment takes effect. In the early stages of treating myositis your muscle fibers are fragile and could be damaged further by such exercises. Physical examination and laboratory tests will help your doctor determine the appropriate time to start an exercise program. But even when strenuous exercise is not recommended it is important to prevent loss of flexibility of your arms legs and other parts of your body by doing range of motion stretching of the joints and muscles. Other physical therapy activities may range from simple exercises at home to formal sessions with a specially trained health professional. They can also include whirlpool baths heat and gentle massage or similar therapies. As you get better your physical therapy program will be adjusted accordingly with more vigorous exercises. Exercising in pools can be very helpful in restoring your muscle function to normal. Getting adequate rest is another important aspect of managing myositis.

During times of increased muscle weakness you need to take frequent rests during the day and to limit your activity to a tolerable level. If you are employed you need to discuss your situation with coworkers, supervisors and your doctors to develop a work plan to accommodate your disease. When your myositis is active you should minimize strong physical activity and your workday should include rest breaks. More activity can be undertaken and fewer rest breaks will be needed as your condition improves but you need to avoid overdoing activity at the first sign of improvement. Your doctor and physical therapist can help decide the proper balance of rest and activity at each stage of myositis. Medications Corticosteroids The most effective drugs in treating myositis are corticosteroids. These drugs are related to hormones produced naturally in the body. Corticosteroids are powerful and can have serious side effects. Some of these side effects include: weight gain Myositis | definition of myositis by Medical dictionary Myositis | definition of myositis by Medical dictionary Definition Myositis is a rare disease in which the muscle fibers and skin are inflamed and damaged, resulting in muscle weakness. There are several types of myositis that affect different parts of the body.

Description The persistent inflammation that is associated with myositis develops slowly over weeks to months and often years, with progressive weakening of the muscles. Later in the course of the disease development muscle wasting or shortening (contracture) may develop. Myositis can range in severity from mild to debilitating. The forms of myositis include: Polymyositis (PM) inflames and weakens muscles in many parts of the body, and especially those parts closest to the trunk. With polymyositis, dysphagia (difficulty, discomfort or pain in speaking or swallowing), fatigue , and pain in the muscles are common. PM rarely affects people under the age of 20, with the peak onset between the ages of 30 and 60. Dermatomyositis (DM) affects both the muscle fibers and skin by damaging the tiny blood vessels (capillaries) that supply blood to the muscle and skin, resulting in muscle weakness, pain, and fatigue. In addition the affected person develops a distinctive patchy, reddish rash on the eyelids, cheeks, bridge of the nose, back or upper chest, elbows, knees, and knuckles.

There may also be hardened, tender bumps (possibly caused by inflammation of fat) under the skin. DM can occur at any age and is more common in females than males. Inclusion Body Myositis (IBM) typically begins after age 50, and is characterized by gradual weakening of muscles throughout the body, including the wrists or fingers, development of dysphagia, and atrophy of forearms and/or thigh muscles. Unlike the other types of myositis, IBM occurs more often in men than women, and also does not respond very well to drug therapy. Juvenile myositis (JM) involves muscle weakness, skin rash, and dysphagia in children. A common characteristic of JM is the formation of calcium deposits in the muscle (calcinosis). These deposits are hard and sometimes painful lumps of calcium under the skin that appear on the child's fingers, hands, elbows, and knees. Painful sores may appear if the lumps break through the skin. The child may also suffer from contractures , which is muscle shortening that results in joints staying bent. About half of the children with JM will have pain in their muscles.

Myositis is rare, affecting about 10 in one million people each year. DM and PM affect mostly women in the forties and fifties but men and children can also affect be affected, some at a young age (between the ages of 5 and 15). About 40,000 people in the United States may have this disease, with about 3,000 to 5,000 children affected. Causes and symptoms Myositis is thought to be an autoimmune disease. The body normally fights infections and disease by producing antibodies and white blood cells called lymphocytes in a process called the immune response. In an autoimmune disease, the immune response is overactive, and the immune system attacks and destroys the body's own normal healthy tissues. There is no known cause to the autoimmune response that results in myositis. However, investigators are studying whether the disease is triggered by such environmental agents as the organism that causes toxoplasmosis , Toxoplasma gondii, the Lyme disease organism, Borrelia burgdorferi, the coxsackievirus, or by food allergies . Some cases of IBM are thought to be inherited.

The first symptoms of most types of myositis are weakness and pain in the muscles of the hips and shoulders. The affected person may have trouble getting up from a chair, lifting the arms above the head, or climbing stairs, and may be too tired to walk or stand. DM and PM mostly affects muscles that are close to and within the trunk of the body, while IBM involves a wider range of muscles. Myositis may make it difficult for the person to speak or swallow. When the disease affects the lungs or chest muscles, the person may have difficulty breathing. If the person has DM, they may develop characteristic rashes . Other symptoms may include fever and joint pain and swelling. The first signs of JM is usually a red and patchy skin rash and/or a red or purplish rash on the eyelids or cheeks that look like allergies . Weak muscles may develop at the same time as the rash, or may develop days, weeks, or months after the appearance of the rash. Other symptoms of JM include falling, a weaker voice (dysophonia), or dysphagia. Calcinosis usually develops later during the course of the disease.

Diagnosis Myositis can a difficult disease to diagnose, because it is rare, because the symptoms develop slowly, and because it can be mistaken for other diseases causing muscle weakness such as limb-girdle muscular dystrophy . Many cases of myositis go undiagnosed for years. The health care provider must rule out other conditions such as hypothyroidism , toxin exposure, drug reactions, and genetic disorders that can also affect muscles. The physical examination will include a complete medical history focusing on symptoms and when they occurred, and blood tests for autoantibodies and muscle enzymes (for example, creatine kinase (CK), which when present in the blood indicates muscle damage). Specialized tests may also be performed, including: an electromyogram, which measures the electrical pattern of the muscles a muscle biopsy, in which a small piece of muscle is removed, stained, and examined by microscopic techniques to determine if muscle fibers are damaged and whether the muscle fibers are being infiltrated by cells of the immune system magnetic resonance imaging (MRI) to identify areas of muscle inflammation. Treatment There is no cure for myositis. However, prompt and aggressive treatment may reduce muscle inflammation and prevent muscle weakness from progressing.

Because of the many different kinds of symptoms and a wide range of reactions to different drugs, each person's treatment for myositis should be individualized. Drugs that are used for treatment include corticosteroids , such as prednisone, to reduce inflammation and improve the body's reaction to infections. Corticosteroids are usually taken in the form of pills, but may also be injected. The amount of creatine kinase (CK) levels in the blood are monitored to determine how well the medicine is working. Corticosteroids may produce a number of side effects, such as weight gain, difficulties in fighting infections, psychiatric changes, sleeping troubles, water retention, bone thinning, facial swelling, diabetes, and cataracts . Corticosteroid therapy usually leads to improvement in myositis symptoms within two to three months, after which the dose can be lowered to avoid the side effects. If the dose of corticosteriods is going to be reduced, it is essential to lower the dose over a period of time. Immunosuppressant drugs are used to slow down the immune system's attack on healthy tissue and improve skin rashes.

Persons may be prescribed these drugs to control myositis if they are unable to tolerate corticosteroids or if the corticosteroids are not accomplishing the desired degree of treatment. Immunosuppressant drugs may also be used in conjunction with corticosteroids so that lower doses of corticosteroids can be used. Immunosuppressant drugs include azathioprine, methotrexate, cyclosporine, tacrolimus, etanercept, and mycophenolate mofetil. Intravenous immunoglobulin (IVIg) appears to aid in improving muscle strength in many persons with myositis, particularly those with DM. It may be less effective in PM, and its role in treating IBM requires more study, although it has been shown to help some patients with IBM if they are diagnosed early. Immunoglobulins are normal proteins in the blood that attack anything foreign in the body, such as viruses and bacteria. IVIg is made from donated blood plasma from people with normal immune systems. Side effects from the the use of IVIg include headache and flu-like symptoms.

Topical cream or ointment forms of some of the medicines, such as prednisone and tacrolimus, can be used to heal and soothe the rash associated with DM. Non-steriodal anti-inflammatory drugs (NSAIDS) such as aspirin or ibuprofen can be used for pain relief. Calcinosis can be treated with prednisone, plaquenil (also called hydroxychloroquine), intravenous immunoglobin (IVIG), cyclosporine, and methotrexate. After drug treatment results in improvement, the affected person begins a program of regular stretching exercises to maintain range of motion in the weakened arms and legs. Physical therapy may be used to prevent permanent muscle shortening. Whirlpool baths, heat, and gentle massages may also provide relief. Adequate rest is necessary, and affected persons should take frequent breaks throughout the day and limit their activity. Patients with throat problems should be evaluated by a speech therapist who can evaluate the swallowing-related problems and make recommendations regarding diet changes and safe swallowing techniques.

Before a woman with myositis becomes pregnant, she should discuss the medicines that she is taking with her health care provider and evaluate the possible risks that she and the baby face if she does become pregnant. Many of the drugs used in the treatment of myositis may be harmful to the fetus or to a breastfed baby. It is recommended that a doctor experienced in the treatment of myositis, assisted by a rheumatologist, dermatologist, or neurologist, be consulted. Oftentimes a patient may have to be treated at a major medical center, where the disease has been seen and treated before. Alternative treatment Various supplements may be used in conjunction with traditional treatment to offset side effects of conventional drug treatment. The use of these suppplements should be approved by the primary health care provider. Immunosuppressant drugs such as methotroxate and cyclophosphamide increase the risk of infection, so a healthy well-balanced diet is required. Methotroxate impairs the body's ability to absorb folic acid , so foods high in folic acid, such as leafy green vegetables, fruits, and folate-fortified breads and cereals are recommended.

The use of folate supplements may also be recommended by the health care provider. Vitamins C and E can be used to help with the pain and infections associated with calcinosis. Corticosteroids may have multiple side effects when taken for long periods of time at high doses. Calcium and Vitamin D are recommended to lower the risk of osteoporosis , a common side effect of prednisone use. Hypertension and fluid retention may be controlled by a diet low in salt. Steroid-induced diabetes (hyperglycemia) can be aided by a diet low in sugar and other simple carbohydrates. Proteinuria, in which the body breaks down protein faster than normal, may mean that more protein should be included in the diet. Weight gain associated with the use of corticosteroids can be managed by the use of the DASH (Dietary Approach to Stop Hypertension) diet, which is high in fruits, vegetables, dietary fiber, and low-fat dairy products. Information concerning this diet, developed by the National Institutes of Health, can be found at [ Weight gain can overtax weakened muscles and should be avoided if possible.

Prognosis The progression of PM and DM varies from person to person, but the lifespan of an affected person is not usually significantly affected. DM responds more favorably to therapy than PM. Overall, many patients do improve and have a functional recovery. About half of the patients recover and can discontinue treatment within 5 years of beginning treatment. In children the chances of a cure are better than in adults, although some children do suffer a relapse. Of the remaining 50%, about 20% will still have the active disease and will require ongoing treatment, while up to 30% may have some remaining muscle weakness. However, IBM is disabling, and most patients will require the use of an assistive device such as a cane, walker, or wheel chair. The older the patient is when contracting IBM, the more rapidly the disease progresses. Prevention Myositis - Symptoms & Information - Patient Education Center Tweet What Is It? Myositis is the medical term for muscle inflammation. In myositis, inflammation damages the fibers of a muscle. This causes muscles to be weak by interfering with the ability of the muscles to contract. Although myositis can cause muscle aches and muscle tenderness, weakness is usually the dominant symptom.

In some cases, myositis is a short-term problem that goes away after a few days or weeks. In other cases, it is part of a chronic (long-term) condition. Chronic forms of myositis can lead to muscle atrophy (wasting and shrinking) and severe disability. There are many different types of myositis, including: Idiopathic inflammatory myopathies. In this rare group of muscle diseases, the cause of the muscle inflammation is unknown (idiopathic). There are three major types: dermatomyositis, polymyositis and inclusion body myositis. In the United States, idiopathic inflammatory myopathies affect about 1 out of every 100,000 people. Polymyositis and dermatomyositis are most common in women, whereas inclusion body myositis affects men more often. Symptoms can start at any age, but the average age of first symptoms is a bit younger in dermatomyositis and polymyositis (age 50) than in inclusion body myositis (age 60).

So far, most of the evidence suggests that polymyositis and dermatomyositis are autoimmune disorders, illnesses in which the immune system mistakenly attacks the body’s own tissues. The muscles of people with inclusion body myositis contain an abnormal protein called amyloid, but the reason it forms is unknown. This amyloid protein is similar to the protein deposited in the brains of people with Alzheimer’s disease, and some experts believe that the two diseases may develop the same way. In inclusion body myositis, the muscle also contains tiny structures that resemble viral particles (called inclusion bodies), although no viral infection has been consistently identified in association with this disease. In dermatomyositis, cancer is found in approximately 10% to 20% of cases. Sometimes, the muscle problem develops first. In other cases, the cancer is detected before the myositis. Myositis that is otherwise quite similar to polymyositis or dermatomyositis may accompany other autoimmune disease such as systemic lupus erythematosus (SLE) or progressive systemic sclerosis (also called scleroderma). Infectious myositis. Myositis sometimes occurs as part of a systemic (whole body) infection, especially a viral infection.

It is especially common among people who have the flu (influenza). Myositis also can be caused by trichinosis, an infection in which tiny parasites invade the muscles. People can develop this infection by eating meat that has not been cooked enough. One type of infectious myositis is called pyomyositis, a bacterial infection that causes one or more pockets of pus (abscesses) inside a muscle. It usually is caused by Staphylococcus (“staph”) bacteria. Pyomyositis is a relatively common infection in developing countries in tropical climates, especially where sanitation and health care are poor. However, it sometimes occurs in the United States, primarily in people who inject illegal drugs and in people infected with HIV. Benign acute myositis. In benign acute myositis, a young child suddenly develops severe leg pain and cannot walk normally. These symptoms are dramatic and frightening, but they usually disappear within a few days. Benign acute myositis usually occurs in children who are recovering from the flu or some other respiratory infection caused by a virus. Doctors are not sure whether the child’s muscle symptoms are caused by the virus itself or by the body’s immune reaction to the virus. Myositis ossificans.

In myositis ossificans, a lump of bony material forms inside a muscle. This usually happens after a muscle injury, especially a deep bruise. Drug-induced myositis. In drug-induced myositis, muscle inflammation occurs as a side effect of a medication or a combination of medicines. Although this is rare, the most common medications that can cause myositis are the cholesterol-lowering drugs called statins, including atorvastatin (Lipitor), lovastatin (Mevacor) and simvastatin (Zocor) and zidovudine (Retrovir), also called AZT, a drug used to treat HIV/AIDS. Symptoms Symptoms of myositis can include muscle weakness, muscle pain and muscle tenderness. Other symptoms vary, depending on the specific cause of myositis: Idiopathic inflammatory myopathies. These conditions typically cause painless muscle weakness that develops slowly over weeks, months or years. Although up to 40% of people with 1 of these conditions have muscle pain, the weakness is usually worse than the pain.

In polymyositis and dermatomyositis, weakness usually affects the muscles near the center of the body (called proximal muscles), including the muscles of the neck, shoulders and hips causing difficult with lifting, reaching over the head, or arising from a chair. Some patients also have difficulty swallowing. In dermatomyositis, skin symptoms accompany muscle problems. These can include purple discoloration of the eyelids, a red rash on the face and neck, or scaly patches, usually on the knuckles. In inclusion body myositis, weakness typically starts in the upper legs and later affects the upper arms and muscles farther away from the center of the body (called distal muscles), including muscles of the hand and wrist and lower legs. Muscle wasting (atrophy) is often prominent. Up to one-half of these patients have trouble swallowing. Infectious myositis. When infectious myositis is caused by the flu, symptoms include not only muscle aches and muscle weakness, but also high fever, chills, sore throat, cough, fatigue and runny nose. When caused by trichinosis, symptoms in the early stages include diarrhea and vomiting.

Later, as the parasites invade the muscles, symptoms can include fever, eye redness with swelling in the lids and muscle pain. Patients with pyomyositis usually have a fever, and the abscessed muscle is painful, tender and slightly swollen. Skin over the muscle may be red and hot. Benign acute myositis. A child suddenly has trouble walking and complains of severe leg pain. This pain is often worst in the calf muscles. In most cases, the child also has a history of recent fever, runny nose, sore throat and other upper respiratory symptoms. Myositis ossificans. A lump appears in the affected muscle, and this lump may hurt when you press it. These symptoms usually begin several weeks after a muscle injury, especially a bruise. Drug-induced myositis. Symptoms include muscle soreness, pain and weakness. These symptoms usually begin soon after a person starts taking a new drug or a combination of drugs. Myositis is more common when a person is taking a combination of lipid-lowering medications, such as gemfibrozil (Lopid) and lovastatin (Mevacor), than when a single medication is used. Diagnosis Your doctor will ask you to describe your symptoms.

It is especially important to describe the exact location of any weakness or muscle pain and how long you have had it. The doctor also will review your medical history and current medications. Next, your doctor will examine you, paying special attention to your muscles and nerves. Depending on what your doctor finds, he or she may order diagnostic tests. Common tests used to diagnose muscle problems include: Blood tests to measure levels of muscle enzymes, auto-antibodies (antibodies directed against one’s own cells or organs) and antibodies to infectious agents An electromyogram, a test that measures the electrical activity of muscles Magnetic resonance imaging (MRI), a painless scan that can identify abnormal muscle and can be used to locate the best site for a biopsy to establish the diagnosis or to monitor the progress of a known type of myositis A standard X-ray or a bone scan if your doctor suspects you have myositis ossificans An ultrasound, computed tomography (CT) scan or MRI if pyomyositis is suspected A muscle biopsy. With this test, the doctor takes a sample of muscle tissue to be checked under the microscope. Muscle biopsy is the best way to establish the diagnosis of myositis; it may be diagnostic if it shows clear muscle inflammation.

However, the results are not always abnormal even in people who have myositis. Expected Duration How long myositis lasts varies depending on the cause: Idiopathic inflammatory myopathies. Polymyositis and dermatomyositis are usually chronic (long-lasting) but typically improve after one to two months of treatment. Inclusion body myositis is also chronic. Since there is no reliably effective treatment for inclusion body myositis, symptoms usually worsen gradually over a period of years. If cancer is associated with the myositis, improvement may occur if the cancer is treated effectively. Infectious myositis. Flu symptoms usually last three to seven days. In trichinosis, symptoms peak in about three weeks, and then gradually subside. For pyomyositis, your doctor will drain the abscess and you will be given antibiotics. Once the infection is gone, healing can start. Recovery can take weeks or even months in people with chronic illnesses. Benign acute myositis. Patients usually recover within three to seven days. Myositis ossificans. In some cases, the bony lump disappears on its own. However, this can take a few months.

If the lump does not go away, it may remain indefinitely or your doctor can remove it surgically. Drug-induced myositis. Symptoms usually disappear once you stop taking the drug. However, this can take weeks or months. Prevention Scientists do not know the cause of most forms of myositis. For this reason, there are no official guidelines for preventing myositis. Only infectious myositis and drug-induced myositis are potentially preventable. To help prevent these illnesses: Get a flu shot each year. Thoroughly cook pork and other meats. Never inject illegal drugs under your skin or into your muscles. With prescription drugs that are injected, the injection site should be as clean as possible. Keep your skin clean. Take the lowest number and lowest doses of medications that are necessary. Routine blood tests to look for drug-induced muscle injury may be helpful as well. Treatment Treatment varies, depending on the type of myositis. Idiopathic inflammatory myopathies. For polymyositis and dermatomyositis, doctors usually begin treatment with a corticosteroid drug, such as prednisone (sold as a generic) or methylprednisolone (Solu-Medrol, others).

If this fails, methotrexate (Rheumatrex) or azathioprine (Imuran) may be added. Intravenous immunoglobulin (an injection of antibodies collected from blood donors) may be effective in cases that fail these other treatments. Other immunosuppressant medications may be recommended to treat dermatomyositis and polymyositis, including cyclosporine, rituximab, mycophenolate mofetil or cyclophosphamide. Unfortunately, there is no reliably effective treatment for inclusion body myositis, although corticosteroid treatment and immunosuppressive therapies (as with polymyositis and dermatomyositis) are often tried for at least several months. If treatment is effective, ongoing therapy may improve strength or prevent worsening weakness. When myositis accompanies another autoimmune disease (such as SLE), treatment of the underlying disease may be helpful; otherwise, treatment of the myositis is similar to that of polymyositis and dermatomyositis. Infectious myositis. If you have the flu, you should rest in bed and drink plenty of fluids. You also can take nonprescription medicines for fever and muscle aches.

If you have trichinosis, your doctor may treat you with mebendazole (Vermox) or albendazole (Albenza), antibiotic drugs that kill the trichinosis parasites. In addition, you should rest and take nonprescription drugs for pain. Your doctor may also prescribe prednisone to reduce inflammation associated with the infection. For pyomyositis, your doctor may recommend drainage of the abscess by making an incision or by inserting a needle. In addition, he or she will prescribe antibiotics to fight the infection. Benign acute myositis. Your child’s doctor will prescribe medication for pain. No other treatment is necessary, because the illness usually gets much better within a few days. Myositis ossificans. Your doctor may wait to see whether the bony lump disappears on its own. If it doesn’t, he or she may recommend surgery to remove the lump. Drug-induced myositis. Your doctor will discontinue any medication thought to be causing myositis. Medications called corticosteroids may help you to recover faster.

When To Call a Professional Make an appointment to see your doctor if you have: Muscle weakness that doesn’t go away A red or purple rash on your face that doesn’t go away or scaly patches on your knuckles Muscle aches that don’t go away with rest and nonprescription pain medication A lump in any muscle, especially if you also have a fever or other symptoms Muscle pain and weakness that begin after you start taking a new medication Call your doctor immediately if: You have a fever together with muscle pain and weakness You have a muscle that becomes hot, painful, swollen and stiff Your child complains of severe leg pain and has trouble walking Prognosis The outlook varies, depending on the type of myositis. Idiopathic inflammatory myopathies. With proper treatment, most people with polymyositis or dermatomyositis eventually regain at least some muscle strength. Often, muscle strength returns to normal. Typically, inclusion body myositis does not improve with treatment. However, the illness usually progresses slowly and does not affect a person’s lifespan unless complications lead to serious illness, such as pneumonia caused by swallowing or breathing problems. Eventually, some patients need a cane to help them walk. Others require a wheelchair.

If a person with dermatomyositis develops cancer, the prognosis may be worse. Medications taken to treat these muscle diseases may cause complications that affect prognosis. For example, serious infections may complicate the use of immune suppressing medications. Infectious myositis. Once the flu passes, muscle symptoms improve. Treatment usually is effective, although recovery can be slow in people with trichinosis. For pyomyositis, the prognosis is good if the infection is treated promptly. If not, the infection can pass into the bloodstream and spread throughout the body. Benign acute myositis. Children typically walk normally again within a few days. Myositis ossificans. The prognosis is very good. If the bony lump does not disappear on its own, your doctor may recommend surgery to remove it. Drug-induced myositis. The prognosis is very good. In most cases, symptoms subside when the drug is stopped. Additional Info National Institute of Arthritis and Musculoskeletal and Skin Diseases Information Clearinghouse Myositis: Symptoms and Causes Cocaine Alcohol Myopathy may occur right after starting a medication, or may occur after taking a drug for months or years. Sometimes it is caused by an interaction between two different medications.

Severe myositis caused by medications is rare. Injury. Vigorous exercise can lead to muscle pain , swelling, and weakness for hours or days after a workout . Inflammation contributes to these symptoms, technically making this a form of myositis. Myositis symptoms after exercise or injury nearly always resolve completely with rest and recovery. Rhabdomyolysis . Rhabdomyolysis occurs when muscles break down quickly. Muscle pain , weakness, and swelling are symptoms of rhabdomyolysis. Urine may also turn a dark brown or red color. Symptoms of Myositis The main symptom of myositis is muscle weakness. The weakness may be noticeable or may only be found with testing. Muscle pain (myalgias) may or may not be present. Continued Dermatomyositis , polymyositis, and other inflammatory myositis conditions tend to cause weakness that gets worse slowly over weeks or months. The weakness affects large muscle groups, including the neck, shoulders, hips, and back. Muscles on both sides are usually affected. The weakness from myositis can lead to falls and make it difficult to get up from a chair or after a fall.

Other symptoms that may be present with inflammatory conditions include: Thickening of the skin on the hands Difficulty swallowing Difficulty breathing People with myositis caused by a virus usually have symptoms of a viral infection , such as runny nose , fever , cough and sore throat , or nausea and diarrhea . But the symptoms of viral infection may go away days or weeks before myositis symptoms begin. Some people with myositis have muscle pain, but many do not. Most muscle pain is not caused by myositis, but by strain injuries, or ordinary illnesses like colds and flu . These and other ordinary muscle pains are called myalgias. Diagnosis of Myositis A doctor may suspect myositis based on a person’s symptoms of muscle weakness or other evidence of myositis. Tests for myositis include: Blood tests. High levels of muscle enzymes, such as creatine kinase , may mean there is muscle inflammation. Other blood tests check for abnormal antibodies that may identify an autoimmune condition. MRI scan. A scanner using a high-powered magnet and a computer creates images of the muscles. An MRI scan can help identify areas of myositis and changes in the muscles over time. EMG.

By inserting needle electrodes into muscles, a doctor can test the response of muscles to electrical nerve signals. EMG can identify muscles that are weak or damaged by myositis. Muscle biopsy . This is the most accurate test for diagnosing myositis. A doctor identifies a weak muscle, makes a small incision, and removes a small sample of muscle tissue for testing. Muscle biopsy leads to a final diagnosis in most people with myositis. There are many causes of muscle weakness and pain more common than myositis, and testing for myositis is not a straightforward process. For these reasons, the process of diagnosing myositis can be long. Continued Myositis -OrthoInfo - AAOS Copyright 2007 American Academy of Orthopaedic Surgeons Myositis Myositis (my-OH-sigh-tiss) is a rare disease in which the immune system chronically inflames the body's own healthy muscle tissue. Persistent inflammation progressively weakens the muscles. No one knows what triggers the immune system's attack. Myositis can take several forms, usually develops slowly over time and can range in severity from mild to debilitating or worse. Both children and adults can get it.

Symptoms Weakness and pain in the muscles of the hips and shoulders is often a first sign of myositis. You may have difficulty getting up from a chair, combing your hair, or climbing stairs. You may become too tired to walk or stand. Myositis can affect the muscles in the front of the neck and throat, making it hard to speak or swallow (dysphagia). When it affects the lungs or chest muscles, you may have trouble breathing. People with a certain form of myositis may also develop a rash on the face, knuckles and other parts of the body. Other possible symptoms include fever and joint pain and swelling. See your doctor right away for diagnosis and treatment. Top of page Diagnosis Myositis can be challenging to diagnose. Symptoms vary by person and your doctor must rule out other conditions that affect muscles (i.e., hypothyroidism, toxin exposure, drug reactions, and genetic disorders). Tests Give your doctor your complete medical history, and describe your symptoms and when they began. Your physical examination will probably include one or more blood tests to look for autoantibodies and muscle enzymes such as creatine kinase (CK).

You may also need other specialized tests, such as an electromyogram (EMG), which measures the electrical pattern of the muscles. Your doctor may request a muscle biopsy, in which a small piece of muscle is removed, stained and examined by microscope to show whether/how fibers are damaged. Sometimes your doctor may use magnetic resonance imaging (MRI) to identify areas where muscle is inflamed. Forms of Myositis Polymyositis (PM) PM inflames and weakens muscles in many parts of the body, especially those closest to the trunk (proximal). Dysphagia is common, as is fatigue and pain in the joints and muscles. Dermatomyositis (DM) DM inflammation damages both muscle fibers and skin. Like PM, you develop muscle weakness, pain and fatigue. In addition, you have a distinctive patchy, reddish rash on the eyelids, cheeks, bridge of the nose, back or upper chest, elbows, knees and knuckles. In some cases, you may develop hardened bumps under the skin. Inclusion Body Myositis (IBM) Symptoms of IBM typically begin after age 50 with very gradual weakening of muscles throughout the body.

You may develop dysphagia, weak wrists or fingers and atrophy of the forearms and/or thigh muscles. Unlike other forms of myositis, IBM occurs more often in men than in women and, unfortunately, there are no effective treatments known for IBM. Juvenile Myositis (JM) Although some children develop juvenile forms of PM and IBM, children usually get juvenile DM with symptoms of muscle weakness, skin rash and dysphagia. Top of page Treatment Although there is no cure for myositis, prompt and aggressive treatment to reduce inflammation of PM and DM can help prevent muscle weakness from progressing and might help restore some of your strength. Medications: Corticosteroids (i.e., prednisone) and other drugs that suppress the immune system (immunosuppresants) may slow down the attack on healthy tissue and improve skin rash. Your doctor will probably repeat blood tests throughout your treatment for myositis to monitor improvement. You may also want to use nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin or ibuprofin for pain relief. Exercise: After drug treatment takes effect, a program of regular stretching exercises prescribed by your doctor can help maintain range of motion in weakened arms and legs.

Physical therapy may also help prevent permanent muscle shortening. You may also want to add whirlpool baths, heat and gentle massage. Rest: Getting enough rest is an important component of managing myositis. Take frequent breaks during the day and limit your activity. Top of page Last reviewed: July 2007 AAOS does not endorse any treatments, procedures, products, or physicians referenced herein. This information is provided as an educational service and is not intended to serve as medical advice. Anyone seeking specific orthopaedic advice or assistance should consult his or her orthopaedic surgeon, or locate one in your area through the AAOS "Find an Orthopaedist" program on this website. Copyright 2007 American Academy of Orthopaedic Surgeons OrthoInfo The American Academy of Orthopaedic Surgeons 9400 West Higgins Road Myositis Myositis Myositis What is Myositis? Myositis is a term meaning inflammation in the muscles. There are several types of myositis, the most common being polymyositis and dermatomyositis. Polymyositis causes muscle weakness around the middle of the body and affects both sides of the body.

Dermatomyositis causes muscle weakness as well as a skin rash. Juvenile dermatomyositis differs from the adult form because of the coexistence of vasculitis (inflammation of blood vessels). Inclusion body myositis mainly affects older individuals. As muscle weakness becomes severe, it is accompanied by muscle wasting and diminished deep-tendon reflexes. Unlike polymyositis and dermatomyositis, the muscle weakness is often not symmetric, and may be prominent in the smaller muscles of the forearms and calves. Myositis Causes Myositis can be brought about by an injury, infection or an autoimmune diseases, such as rheumatoid arthritis and lupus. Viruses, including the common cold, flu and human immunodeficiency virus (HIV), also are associated with myositis. Certain medications (such as statins) and illegal drugs (like cocaine) can cause myositis, as well. Myositis Symptoms In addition to muscle weakness, people with myositis may have muscle pain, fatigue, difficulty moving limbs, risk of falls or difficulty swallowing or breathing.

Polymyositis is characterized by symptom flares, muscle weakness (especially in the thighs, hips and shoulders), lung issues, joint pain, fever, weight loss, Raynaud’s phenomenon and a general ill feeling. Dermatomyositis is characterized by a skin rash that may precede, accompany or follow muscle weakness. Patchy purple or red rashes may develop on the eyelids or on muscles used for extending joints, like the knuckles, elbows, knees and toes. Rashes can appear on the face, neck, chest and back. People with dermatomyositis may also have weight loss, fever, lung issues and sensitivity to light. Myositis Diagnosis There are many reasons for someone to have muscle weakness and fatigue. This can make diagnosing myositis a long and challenging process. Doctors will rely on physical examination, imaging scans, lab tests and finally a muscle biopsy to confirm a diagnose of myositis. Myositis Treatment There is no cure for myositis, but symptoms can be managed. Typically, treatment begins with high doses of corticosteroids to quickly reduce inflammation.

However, myositis varies from person to person, so it is important to treat the underlying cause of the disease, be it antibiotics for infections or disease-modifying antirheumatic drugs (DMARDs) for autoimmune disease. Disease-modifying immunosuppressant drugs, such as azathioprine and methotrexate, may be used when corticosteroids fail to work. Intravenous immunoglobulin may also be used. Myositis Self Care Self care involves taking a proactive part in treatment. Exercise is a very important part of the treatment plan for myositis. It is important to keep muscles strong and flexible. Physical therapy can help prevent muscle atrophy and regain muscle strength and range of motion. Doctors may also recommend supplements that help support muscle strength. Advertisement Myositis - Cedars-Sinai Myositis Print Myositis is a rare group of diseases characterized by inflamed muscles, which can cause prolonged muscle fatigue and weakness. The group includes the autoimmune disorders juvenile myositis, dermatomyositis and polymyositis , as well as inclusion body myositis (IBM).

These diseases, sometimes referred to as inflammatory myopathies, can affect the internal organs, skin and multiple muscle groups of patients. Symptoms While each myositis condition has its own unique characteristics and treatments, all of them involve chronic muscle inflammation. This inflammation usually results in muscle fatigue and weakness, frequent falling, swelling of the feet and legs, and muscular and joint pain. Early symptoms in patients with myositis include: Difficulty standing up from a seated position Difficulty climbing stairs Fatigue after standing or walking a long time Trouble swallowing or breathing Muscle pain that does not subside within a few weeks A red or purple colored rash on the eyelids, elbows, knees and knuckles Causes and Risk Factors Juvenile myositis generally affects children from 5 to 15 years old. Dermatomyositis can affect all ethnic groups and both genders; however, women have been shown to be twice as likely to develop the disease. The risk of developing polymyositis increases with age and shows the highest rates of incidence between the ages of 35 to 44 and 55 to 64. Women are also twice as likely as men to develop polymyositis.

The risk of developing IBM increases with age and usually appears in patients over the age of 50; however, patients may develop symptoms as early as their 30s. IBM is twice as likely to develop in men as in women. Diagnosis Diagnosis of myositis often begins with a physical examination, to provide physicians with a better understanding of patients’ overall condition. An accurate diagnosis is important, as treatment plans are highly specialized. The physician also may use a variety of other diagnostic tools, including blood tests, muscle biopsy, magnetic resonance imaging (MRI) , electromyography (EMG) or lumbar puncture (spinal tap). Treatments The symptoms and severity of myositis can vary greatly between individuals; an individual treatment plan developed by a knowledgeable medical team is recommended. Treatments may include both nondrug and drug-based therapies, including medications such as immunosuppressants or corticosteroids, which slow the body’s immune system and reduce the body’s attack on its muscles, skin and organs. Physical therapy also may be included as a treatment to help improve the patient's physical activity and quality of life.

Question: 'Myositis' affects which part of the body?
Answer: Muscles