Myositis: Symptoms, Causes, Diagnosis, and Treatment

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Myositis is a rare condition of which most people seem unaware. For those who’ve been diagnosed with it or know someone who has, it can be a life-changing event.

In layman’s terms, myositis is a group of diseases that causes muscle weakness, pain, and inflammation, resulting in significant impairment to daily life.

Globally, 5 to 22 in every 100,000 people are at risk every year. It’s a rare disease that’s difficult to diagnose with causes unknown and symptoms that appear gradually.

This blog explores the types and causes of myositis, its diagnosis, treatment, and its impact on individuals.

What Is Myositis?

Myositis, or idiopathic inflammatory myopathy (IIM), is a rare and life-threatening autoimmune disorder characterized by chronic proximal muscle inflammation and weakness. The condition occurs when the body’s immune system mistakenly attacks its muscles or healthy tissues leading to inflammation, pain, and weakness.

Types of Myositis 

There are several types of myositis, each with unique characteristics, symptoms, causes, and treatments. The following are five major subtypes of myositis:

1. Dermatomyositis (DM): This affects skin and muscles with characteristic skin rashes of Gottron’s papules and heliotrope rash.
2. Polymyositis (PM): This affects the trunk (neck, hips, back and shoulders) and worsens over time.
3. Sporadic inclusion body myositis (IBM): This is the most common type of myositis, with progressive weakness and muscle atrophy found in people over 50.
4. Necrotizing Myopathy: A newly defined form of myositis characterized by increased evidence of muscle cell death (necrosis). 
5. Juvenile Myositis: This is found in children under 18 and is characterized by muscle weakness in the trunk.

Symptoms of Myositis

Myositis disease has many symptoms, the most common one being muscle weakness. Symptoms appear gradually and worsen as the condition progresses.

The symptoms of myositis can vary depending on the severity of each type of condition.

Dermatomyositis (DM) Symptoms

• Scaly, rough skin with red, purple or dark rash
• Gottron’s papules (scaly bumps on knuckles, elbows, and knees)
• Weakness, pain, and tenderness in muscles
• Difficulty swallowing, fatigue
• Joint inflammation

Polymyositis (PM) Symptoms

• Muscle weakness
• Aching muscles and fatigue
• Trouble sitting up, or getting up after a fall
• Difficulty swallowing
• Difficulty standing straight
• Thickening of the skin on the hands

Sporadic Inclusion Body Myositis (IBM) Symptoms

• Difficulty walking, frequent falls
• Tripping and loss of balance
• Trouble rising from a seated position
• Weakened hand grip
• Diminished deep tendon reflexes

Necrotizing Myopathy Symptoms

• Rapid onset of muscle weakness
• Difficulty standing or lifting objects
• Shortness of breath
• Dysphagia
• Raynaud’s phenomenon

Juvenile Myositis Symptoms

• Gottron’s papules, heliotrope rashes
• Motor function difficulties (trouble climbing stairs, standing, getting dressed, etc.)
• Hardened lumps of calcium under the skin
• Muscle weakness
• Hoarse-sounding voice

Causes of Myositis

Autoimmune diseases are the result of the immune system accidentally attacking the body instead of protecting it.

It’s unclear what triggers this behaviour; hence the exact cause of myositis is unknown. However, researchers believe myositis can be the result of a variety of factors, such as the following:

1. Genetics: It can be genetically inherited at birth, often from an abnormal gene mutation from a parent.
2. Infection: A viral or bacterial infection (from the common cold, flu, or HIV) may cause myositis.
3. Drug-induced myositis: Some medications, like statins, omeprazole, colchicine, etc., can cause myositis as a side effect.
4. Alcohol and substance abuse: Long-term alcohol and drug abuse, smoking, etc., may also cause myositis.
5. Cancer-associated myositis (CAM): Sometimes, myositis can be a sign of underlying cancer, such as lung cancer or ovarian cancer.

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