MRI guided wire localization muscle biopsy in a child with juvenile dermatomyositis

Victoria C Tuen,Jane M Matsumoto,Shannon N Zingula,Christopher Moir,Ann M Reed,David A Woodrum

doi:10.1186/1546-0096-11-15

Victoria C Tuen, Jane M Matsumoto + Show 4 more

Open Access

https://doi.org/10.1186/1546-0096-11-15

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Abstract

A novel technique for preoperative MRI guided wire localization for targeted surgical excisional biopsy of muscle is described in a pediatric patient with juvenile dermatomyositis (JDM). This technique allows for preoperative localization of abnormalities seen only with MRI. Using this technique, the patient underwent successful targeted muscle biopsy for confirmation of the diagnosis and staging of dermatomyositis.

Highlights

Juvenile dermatomyositis (JDM) is an autoimmune, inflammatory myopathy
The muscle biopsy can be difficult because even within a single muscle group there can be heterogeneous inflammatory involvement. This patchy muscular involvement can only be delineated with magnetic resonance imaging (MRI) [3]
Given the results of the skin and muscle biopsies, in addition to the clinical picture, the diagnosis was determined to be consistent with moderately severe active dermatomyositis

Summary

Introduction

Juvenile dermatomyositis (JDM) is an autoimmune, inflammatory myopathy. Dermatologic and muscle manifestations are most common, typically consisting of a heliotrope rash involving the eyelids, erythematous rash on the extensor surfaces (Gottron’s papules), and proximal muscle weakness [1,2]. Surgical muscle biopsy is diagnostic for cases in which the clinical presentation may not be clear. This case report presents a novel methodology for preoperative muscle localization in a patient needing surgical excisional biopsy for diagnosis of JDM.

Results

Conclusion