Muscle ultrasound in myositis

Muscle ultrasound (US) is a useful new tool for diagnosis and evaluation in myositis, according to Prof Myma Albayda, Associate Professor of Medicine, Johns Hopkins School of Medicine, US, who spoke on the topic at the Irish Society for Rheumatology (ISR) 2026 Spring Meeting.

Prof Albayda is a dedicated leading researcher in the field, with a focus on idiopathic inflammatory myopathies (IIM), particularly inclusion body myositis (IBM), and has published widely on the use of US in myositis.

Speaking to the Medical Independent (MI) before her presentation, ISR President Dr Andrew Cairns said that while musculoskeletal US is often used to examine the joints of rheumatic disease patients, muscle US has not to date been a major area of practice, so there was a lot of interest in Prof Albayda’s findings.

She told the meeting that the use of muscle US to evaluate skeletal muscle in myositis is gaining interest, especially in chronic disease, where fat replacement and fibrosis are detected readily by this modality. Findings to date support it as a sensitive evaluation tool for IIM, capable of evaluating muscle structure and quality.

Chronic muscle diseases such as IBM, which is frequently confused with polymyositis by biopsy, is well suited for evaluation by US.

Prof Albayda pointed out that US is useful for screening, diagnosis, and follow-up (monitoring course of disease and treatment response).

Currently, inflammation is still best discriminated by MRI, she acknowledged, “but it is discernible on US as changes in echosensitivity and echotexture.”

US can also be useful for targeting muscle procedures in real time, she stated.

“Muscle ultrasound is feasible to do for our patients, it is available everywhere and is capable of showing us changes. It is becoming a [useful] alternative for MRI,” Prof Albayda told MI, adding that the use of artificial intelligence will increase its role and capability.