Muscle biopsy in myositis: What the rheumatologist needs to know

Ashirwad Merve; Udo Schneider; Eleanna Kara; Charalampia Papadopoulou; Werner Stenzel

doi:10.1016/j.berh.2022.101763

Muscle biopsy in myositis: What the rheumatologist needs to know

Best Pract Res Clin Rheumatol. 2022 Jun;36(2):101763. doi: 10.1016/j.berh.2022.101763. Epub 2022 Jun 28.

Authors

Ashirwad Merve¹, Udo Schneider², Eleanna Kara³, Charalampia Papadopoulou⁴, Werner Stenzel⁵

Affiliations

¹ Department of Neuropathology, UCL Institute of Neurology, National Hospital for Neurology and Neurosurgery, University College London Hospitals, London, UK; Department of Histopathology, Great Ormond Street Hospital for Children, London, UK.
² Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Rheumatology, Charitéplatz 1, 10117 Berlin, Germany.
³ Department of Neuropathology, UCL Institute of Neurology, National Hospital for Neurology and Neurosurgery, University College London Hospitals, London, UK.
⁴ Department of Paediatric Rheumatology, Great Ormond Street Hospital for Children, London, UK.
⁵ Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Neurology, Charitéplatz 1, 10117 Berlin, Germany. Electronic address: werner.stenzel@charite.de.

PMID: 35773136
DOI: 10.1016/j.berh.2022.101763

Abstract

The appropriate analysis of skeletal muscle tissues is a key element in many diagnostic procedures and can deliver valuable information about the organ that is affected. Although arguably the frequency of muscle biopsy may be declining in certain domains where genetic analysis is now the first line of diagnostic evaluation, it still has an important role in assessment of patients with neuromuscular disorders such as congenital myopathies, muscular dystrophies, metabolic and inflammatory diseases. Here, we have comprehensively discussed the aspects of a modern and fruitful approach to muscle biopsy histopathological studies in rheumatological disorders. We have focussed on the neuromuscular involvement in myositis and its differential diagnoses in both adult and paediatric settings. We have also covered the clinical indications for the biopsy, technical aspects and practical points relevant for the rheumatologists. Finally, we have critically discussed the current and future opportunities that a muscle biopsy may offer and its limitations.

Keywords: Adult; Biopsy; Histopathology; Muscle; Myositis; Paediatric.

Publication types

Review

MeSH terms

Adult
Biopsy / methods
Child
Humans
Muscle, Skeletal / pathology
Muscular Diseases*
Myositis* / diagnosis
Myositis* / pathology
Rheumatologists