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Updated: Nov 23, 2025

Quantitative Magnetic Resonance Imaging of Skeletal Muscle Disease
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Distinct MR features in scleroderma associated myopathy.

Shivani Ahlawat1, Julie Paik2, Filippo Del Grande3,4

  • 1The Russell H. Morgan Department of Radiology & Radiological Science, The Johns Hopkins Medical Institutions, 600 North Wolfe Street, Baltimore, MD, 21287, USA. sahlawa1@jhmi.edu.

La Radiologia Medica
|January 4, 2021
PubMed
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Magnetic Resonance Imaging (MRI) can differentiate fibrosing (FM) from non-fibrosing (NFM) systemic sclerosis (SSc)-associated myopathy. FM shows more edema, while NFM indicates chronic muscle damage on MRI.

Area of Science:

  • Radiology
  • Rheumatology
  • Neurology

Background:

  • Systemic sclerosis (SSc) can cause myopathy, presenting as fibrosing (FM) or non-fibrosing (NFM) forms.
  • Differentiating between FM and NFM is crucial for appropriate patient management and treatment strategies.

Purpose of the Study:

  • To compare MRI features between fibrosing (FM) and non-fibrosing (NFM) systemic sclerosis (SSc)-associated myopathy.
  • To identify specific MRI markers that can distinguish these two SSc myopathy subtypes.

Main Methods:

  • Bilateral thigh MRI, including T1-weighted, STIR, and Diffusion-Weighted Imaging/Apparent Diffusion Coefficient (DWI/ADC) mapping, was performed on 10 FM and 14 NFM patients.
  • Three blinded observers evaluated 36 muscles per patient for intramuscular edema, fascial edema, fatty replacement, and atrophy, and measured ADC values.
Keywords:
Diffusion weighted imagingFibrosisMagnetic resonance imagingMyopathyScleroderma

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  • Statistical analyses, including Fisher's exact test and Student's t-test, were used to compare MRI findings with histological diagnoses.

    • Main Results:

    • Intramuscular edema was significantly more prevalent in FM (p < 0.0001).
    • Elevated intramuscular signal on DWI was more common in FM (p < 0.0001 for both low and high b-values).
    • NFM showed significantly more fatty replacement (p < 0.0001) and atrophy (p < 0.0001) on T1-weighted imaging.

    Conclusions:

    • MRI findings of intramuscular and fascial edema are more indicative of fibrosing myopathy in SSc.
    • MRI markers of chronic muscle damage, such as fatty replacement and atrophy, are more frequently observed in non-fibrosing myopathy associated with SSc.