Imaging findings of scleroderma-associated myopathy: A systematic literature review

source extracted confidence: high 2026-04-09
#humans #scleroderma-systemic #muscular-diseases #muscle-skeletal #magnetic-resonance-imaging

Imaging findings of scleroderma-associated myopathy: A systematic literature review

Ingrid et al., 2025 | Semin Arthritis Rheum | Systematic Review

Citation

Ingrid Elvina, Bavanendrakumar Mathuja, ... Ross Laura. Imaging findings of scleroderma-associated myopathy: A systematic literature review. Semin Arthritis Rheum. 2025-Jun;72:152672. doi:10.1016/j.semarthrit.2025.152672

Abstract

AIMS: Systemic sclerosis (SSc) affects skeletal muscle directly, with SSc-associated myopathy (SSc-myopathy) increasingly recognised as a distinct immune-mediated myopathy. Manual muscle testing and creatine kinase (CK) are insensitive diagnostic tools for SSc-myopathy. We aimed to evaluate the role of imaging in SSc-myopathy diagnosis. METHODS: A systematic search of MEDLINE(Ovid), Pubmed, and EMBASE databases was performed to identify studies of ≥10 SSc patients that reported skeletal muscle imaging results. Eligibility criteria were defined a priori. Risk of bias assessment was performed using the National Heart, Lung and Blood Institute (NHLBI) quality assessment tool. Descriptive summaries were used to present data owing to inter-study heterogeneity. RESULTS: Of 2426 studies identified, 17 articles met the inclusion criteria. Imaging modalities varied, but magnetic resonance imaging (MRI) was the most commonly applied imaging technique (n = 9 studies). Abnormalities on MRI were reported in 38-100 % of patients and included muscle oedema, atrophy, and fatty infiltration. Changes were observed in skeletal muscles (n = 14 studies), axial muscles (n = 1), masseter muscle (n = 1), and accessory respiratory muscles (n = 2). Blood oxygenation level-dependent MRI, dynamic contrast-enhanced ultrasound, and scintigraphic evaluation have each been used to assess skeletal muscle perfusion. A lack of correlation between creatine kinase, clinical weakness, and imaging findings was consistently reported. We were unable to identify any distinct imaging patterns or relationship between imaging and histopathological skeletal muscle abnormalities owing to limited data available. CONCLUSION: Imaging detects inflammatory, atrophic, and vasculopathic changes in the skeletal musculature of SSc patients. The discordance between clinical assessment and imaging findings underscores the potential role for muscle imaging to both screen and diagnose SSc-myopathy.

Key Findings

Of 2426 studies identified, 17 articles met the inclusion criteria. Imaging modalities varied, but magnetic resonance imaging (MRI) was the most commonly applied imaging technique (n = 9 studies). Abnormalities on MRI were reported in 38-100 % of patients and included muscle oedema, atrophy, and fatty infiltration. Changes were observed in skeletal muscles (n = 14 studies), axial muscles (n = 1), masseter muscle (n = 1), and accessory respiratory muscles (n = 2). Blood oxygenation level-dependen

Outcomes Measured

  • inflammatory markers

Population

Field Value
Population See abstract
Sample Size 9
Age Range See abstract
Condition See abstract

MeSH Terms

  • Humans
  • Scleroderma, Systemic
  • Muscular Diseases
  • Muscle, Skeletal
  • Magnetic Resonance Imaging

Evidence Classification

  • Level: Systematic Review
  • Publication Types: Journal Article, Systematic Review
  • Vertical: creatine

Provenance

Source extracted via PubMed E-utilities API on 2026-04-09