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Whole-body muscle MRI to detect myopathies in non-extrapyramidal bent spine syndrome

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Abstract

Objective

Bent spine syndrome (BSS), defined as an abnormal forward flexion of the trunk resolving in supine position, is usually related to parkinsonism, but can also be encountered in myopathies. This study evaluates whole-body muscle MRI (WB-mMRI) as a tool for detecting underlying myopathy in non-extrapyramidal BSS.

Materials and methods

Forty-three patients (90 % women; 53–86 years old) with a non-extrapyramidal BSS were prospectively included. All underwent a 1.5-T WB-mMRI and a nerve conduction study. Muscle biopsy was performed if a myopathy could not be eliminated based on clinical examination and all tests. Systematic MRI interpretation focused on peripheral and axial muscle injury; spinal posture and incidental findings were also reported.

Results

WB-mMRI was completed for all patients, with 13 muscle biopsies ultimately needed and myopathy revealed as the final etiological diagnosis in five cases (12 %). All biopsy-proven myopathies were detected by the WB-mMRI. Relevant incidental MRI findings were made in seven patients.

Conclusions

This study supports WB-mMRI as a sensitive and feasible tool for detecting myopathy in BSS patients. Associated with electroneuromyography, it can better indicate when a muscle biopsy is needed and guide it when required. Rigorous radiological interpretation is mandatory, so as not to miss incidental findings of clinical consequence.

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Acknowledgments

The authors wish to thank Dr. Nicole Araneta for her valuable comments on the manuscript and Dr. François Severac for his help in the analysis of the statistics.

Conflict of interest

The authors declare that they have no conflicts of interest.

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Authors and Affiliations

  1. Service de Radiologie B, Nouvel Hôpital Civil - Hôpitaux Universitaires de Strasbourg, 1 place de l’hôpital, 67000, Strasbourg, France

    Mickaël Ohana

  2. Service de Neurologie, AP-HP – Hôpital Raymond Poincaré, 104 boulevard Raymond Poincaré, 92380, Garches, France

    Marie-Christine Durand

  3. Service de Rhumatologie, AP-HP – Hôpital Raymond Poincaré, 104 boulevard Raymond Poincaré, 92380, Garches, France

    Catherine Marty & Jean-Philippe Lazareth

  4. Service de Neuropathologie, APH-HP – Hôpital de la Pitié-Salpêtrière, 47–83 Boulevard de l’Hôpital, 75651, Paris, France

    Thierry Maisonobe

  5. Service de Radiologie, AP-HP – Hôpital Raymond Poincaré, 104 boulevard Raymond Poincaré, 92380, Garches, France

    Dominique Mompoint & Robert-Yves Carlier

Authors
  1. Mickaël Ohana
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  2. Marie-Christine Durand
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Correspondence to Mickaël Ohana.

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Ohana, M., Durand, MC., Marty, C. et al. Whole-body muscle MRI to detect myopathies in non-extrapyramidal bent spine syndrome. Skeletal Radiol 43, 1113–1122 (2014). https://doi.org/10.1007/s00256-014-1909-3

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  • DOI: https://doi.org/10.1007/s00256-014-1909-3

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