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Arthritis in Idiopathic Inflammatory Myopathies

  • Inflammatory Muscle Disease (I Lundberg and L Diederichsen, Section Editors)
  • Published:
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Abstract

Purpose of Review

Arthritis is a well-recognized symptom of idiopathic inflammatory myopathies (IIM). We provide a summary of available data regarding the epidemiology, clinical characteristics, and autoantibody associations of joint involvement in various forms of IIM.

Recent Findings

Arthritis is reported in 18–55% of patients with IIM. It is particularly frequent (20–70%) in those with antisynthetase syndrome (ASS); highest prevalence is associated with anti-Jo-1 positivity. Most common manifestation is non-erosive polyarthritis. X-ray erosions may be found occasionally in ASS, particularly in patients with overlap with rheumatoid arthritis (RA). Arthritis is often present at the time of IIM diagnosis and it may even precede the onset of muscle weakness. Arthritis may in some cases be the main disease manifestation responsible for the disease burden in patients with IIM.

Summary

Arthritis is a frequent symptom of IIM. Polyarthritis of small joints of the hands is the most frequent clinical manifestation. Arthritis may be the first or dominant symptom in IIM and therefore patients may be initially misdiagnosed as having RA. Particularly in seronegative RA patients with interstitial lung disease or Raynaud’s phenomenon, the possibility of IIM should be considered.

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Funding

The work on myositis is supported by the Czech Ministry of Health - Conceptual Development of Research Organization 00023728 (Institute of Rheumatology) and by a grant from Czech Health Research Council Nr. 16-33746A.

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Authors and Affiliations

  1. Institute of Rheumatology, Na Slupi 4, 128 50, Prague, Czech Republic

    Martin Klein, Heřman Mann & Jiří Vencovský

  2. Department of Rheumatology, 1st Medical Faculty, Charles University, Prague, Czech Republic

    Martin Klein, Heřman Mann & Jiří Vencovský

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Correspondence to Jiří Vencovský.

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Dr. Vencovsky reports grants from Czech Health Research Council and grants from Czech Ministery of Health, during the conduct of the study. Dr. Klein and Dr. Mann have nothing to disclose.

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ESM 1:

An example of subluxing arthropathy in DIP joints in a patient with anti-Jo-1 positive antisynthetase syndrome with a DM-like rash is shown. DIP of the 4th finger on the right hand had to be surgically stabilized due to the extreme joint laxity in this patient. (MOV 62157 kb)

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Klein, M., Mann, H. & Vencovský, J. Arthritis in Idiopathic Inflammatory Myopathies. Curr Rheumatol Rep 21, 70 (2019). https://doi.org/10.1007/s11926-019-0878-x

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