Several other measures have been developed and partially validated to assess disease activity and damage in certain target organs, such as the skin or muscle, or in certain populations, such as in patients with juvenile dermatomyositis. Some of the tools are under copyright, and require specific citation when used in publications. The excel file here provides a listing of all of the tools, authors and publishers. Additional permissions are often required, and we request you check with authors and the journals for permission to use specific tools.

The tools listed below, including their validation and performance characteristics, have been reviewed in the following article:

The IMACS Outcomes Repository Variable List is a data dictionary of the variable names used in the IMACS Outcomes Repository. It is published here to facilitate data sharing of core set measure data.

Cutaneous Assessment Tool (CAT)

Description

Clinical care and therapeutic trials in idiopathic inflammatory myopathies (IIM) require accurate and consistent assessment of cutaneous involvement. The Cutaneous Assessment Tool (CAT) was designed to measure skin activity and damage in IIM. The CAT includes 10 activity, 4 damage and 7 combined lesions. The CAT has been preliminarily validated in a large population of juvenile myositis patients and shown good reliability. The CAT is a promising, semi-quantitative tool to comprehensively assess skin disease activity and damage in IIM.

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References

  1. Huber AM, Dugan EM, Lachenbruch PA, Feldman BM, Perez MD, Zemel LS, Lindsley CB, Rennebohm RM, Wallace CA, Passo MH, Reed AM, Bowyer SL, Ballinger SH, Miller FW, Rider LG; Juvenile Dermatomyositis Disease Activity Collaborative Study Group Preliminary validation and clinical meaning of the Cutaneous Assessment Tool in juvenile dermatomyositis. Arthritis Rheum. 2008 Feb 15;59(2):214-21. [Pub Med Huber AM, Dugan EM, Lachenbruch PA, Feldman BM, Perez MD, Zemel LS, Lindsley CB, Rennebohm RM, Wallace CA, Passo MH, Reed AM, Bowyer SL, Ballinger SH, Miller FW, Rider LG; Juvenile Dermatomyositis Disease Activity Collaborative Study Group Preliminary validation and clinical meaning of the Cutaneous Assessment Tool in juvenile dermatomyositis. Arthritis Rheum. 2008 Feb 15;59(2):214-21.]
    This is the primary publication of the Cutaneous Assessment Tool. Please seek permission to use from the publisher and authors.
     
  2. Huber AM, Lachenbruch PA, Dugan EM, Miller FW, Rider LG; For the Juvenile Dermatomyositis Disease Activity Collaborative Study Group Additional members of the Juvenile Dermatomyositis Disease Activity Collaborative Study Group are listed in Appendix A. Alternative scoring of the cutaneous assessment tool in juvenile dermatomyositis: Results using abbreviated formats. Arthritis Rheum. 2008 Mar 15;59(3):352-356. [Pub Med Huber AM, Lachenbruch PA, Dugan EM, Miller FW, Rider LG; For the Juvenile Dermatomyositis Disease Activity Collaborative Study Group Additional members of the Juvenile Dermatomyositis Disease Activity Collaborative Study Group are listed in Appendix A. Alternative scoring of the cutaneous assessment tool in juvenile dermatomyositis: Results using abbreviated formats. Arthritis Rheum. 2008 Mar 15;59(3):352-356.]
    This is the primary publication of the shortened version of the Cutaneous Assessment Tool. Please seek permission to use from the publisher and authors.
     
  3. Huber AM, Dugan EM, Lachenbruch PA, Feldman BM, Perez MD, Zemel LS, Lindsley CB, Rennebohm RM, Wallace CA, Passo MH, Reed AM, Bowyer SL, Ballinger SH, Miller FW, Rider LG; Juvenile Dermatomyositis Disease Activity Collaborative Study Group. The Cutaneous Assessment Tool (CAT): development and reliability in juvenile idiopathic inflammatory myopathy. Rheumatology (Oxford). 2007 Oct;46(10):1606-11. [Abstract Huber AM, Dugan EM, Lachenbruch PA, Feldman BM, Perez MD, Zemel LS, Lindsley CB, Rennebohm RM, Wallace CA, Passo MH, Reed AM, Bowyer SL, Ballinger SH, Miller FW, Rider LG; Juvenile Dermatomyositis Disease Activity Collaborative Study Group. The Cutaneous Assessment Tool (CAT): development and reliability in juvenile idiopathic inflammatory myopathy. Rheumatology (Oxford). 2007 Oct;46(10):1606-11.]
  4. Dugan EM, Huber AM, Miller FW, and Rider LG; Photoessay of the idiopathic inflammatory myopathies. Dermatology Online Journal. 2009;15(2):1. [Abstract Dugan EM, Huber AM, Miller FW, and Rider LG; Photoessay of the idiopathic inflammatory myopathies. Dermatology Online Journal. 2009;15(2):1.] [Dermatology Online Journal Dugan EM, Huber AM, Miller FW, and Rider LG; Photoessay of the idiopathic inflammatory myopathies. Dermatology Online Journal. 2009;15(2):1.]
    Photo-atlas to provide examples and training for the Cutaneous Assessment Tool.
     
  5. Tiao J, Feng R, Berger EM, Brandsema JF, Coughlin CC, Khan N, Kichula EA, Lerman MA, Lvovich S, McMahon PJ, Rider LG, Rubin AI, Scalzi LV, Smith DM, Taxter AJ, Treat JR, Williams RP, Yum SW, Okawa J, Werth VP. Evaluation of the reliability of the Cutaneous Dermatomyositis Disease Area and Severity Index and the Cutaneous Assessment Tool-Binary Method in juvenile dermatomyositis among paediatric dermatologists, rheumatologists and neurologists. Br J Dermatol. 2017 Oct;177(4):1086-1092. doi: 10.1111/bjd.15596. [Abstract Tiao J, Feng R, Berger EM, Brandsema JF, Coughlin CC, Khan N, Kichula EA, Lerman MA, Lvovich S, McMahon PJ, Rider LG, Rubin AI, Scalzi LV, Smith DM, Taxter AJ, Treat JR, Williams RP, Yum SW, Okawa J, Werth VP. Evaluation of the reliability of the Cutaneous Dermatomyositis Disease Area and Severity Index and the Cutaneous Assessment Tool-Binary Method in juvenile dermatomyositis among paediatric dermatologists, rheumatologists and neurologists. Br J Dermatol. 2017 Oct;177(4):1086-1092. doi: 10.1111/bjd.15596.] 
  6. Campanilho-Marques R, Almeida B, Deakin C, Arnold K, Gallot N, de Iorio M, Nistala K, Pilkington CA, Wedderburn LR; Juvenile Dermatomyositis Research Group. Comparison of the Utility and Validity of Three Scoring Tools to Measure Skin Involvement in Patients With Juvenile Dermatomyositis. Arthritis Care Res (Hoboken). 2016 Oct;68(10):1514-21. doi: 10.1002/acr.22867. [Abstract Campanilho-Marques R, Almeida B, Deakin C, Arnold K, Gallot N, de Iorio M, Nistala K, Pilkington CA, Wedderburn LR; Juvenile Dermatomyositis Research Group. Comparison of the Utility and Validity of Three Scoring Tools to Measure Skin Involvement in Patients With Juvenile Dermatomyositis. Arthritis Care Res (Hoboken). 2016 Oct;68(10):1514-21. doi: 10.1002/acr.22867.] 
  7. Goreshi R, Okawa J, Rose M, Feng R, Lee LA, Hansen CB, Bangert CA, Connolly MK, Davis MD, Callen JP, Fett NM, Fakharzadeh SS, Clarke JT, Werth VP. Evaluation of reliability, validity, and responsiveness of the CDASI and the CAT-BM. J Invest Dermatol. 2012 Apr;132(4):1117-24. doi: 10.1038/jid.2011.440. [Abstract Goreshi R, Okawa J, Rose M, Feng R, Lee LA, Hansen CB, Bangert CA, Connolly MK, Davis MD, Callen JP, Fett NM, Fakharzadeh SS, Clarke JT, Werth VP. Evaluation of reliability, validity, and responsiveness of the CDASI and the CAT-BM. J Invest Dermatol. 2012 Apr;132(4):1117-24. doi: 10.1038/jid.2011.440.]

Disease Activity Score

Description

This validated tool has been developed by Dr. Lauren Pachman's group for assessment of global disease activity in juvenile dermatomyositis. The tool assesses muscle and cutaneous manifestations, including vasculopathic features, based on a bedside clinical assessment. Although the Disease Activity Score is not currently an IMACS Core Set Measure of Disease Activity, it is a core set activity measure for juvenile dermatomyositis that is endorsed by the Paediatric Rheumatology International Trials Organisation (PRINTO), IMACS members have agreed to include this measure in future studies of adult and juvenile myositis. The available version of the tool captures additional data that is not currently being scored, but is undergoing further testing. This tool is part of the IMACS Trials Outcomes Data Repository.

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References

  1. Smith RL, Sundberg J, Shamiyah E, Dyer A, Pachman LM. Skin involvement in juvenile dermatomyositis is associated with loss of end row nailfold capillary loops, J Rheumatol., 2004 Aug, 31(8):1644-9. [Pub Med Smith RL, Sundberg J, Shamiyah E, Dyer A, Pachman LM. Skin involvement in juvenile dermatomyositis is associated with loss of end row nailfold capillary loops, J Rheumatol., 2004 Aug, 31(8):1644-9.]
    This is the primary publication of the Disease Activity Score. Please seek permission to use from the publisher and authors.
     
  2. Campanilho-Marques R, Almeida B, Deakin C, Arnold K, Gallot N, de Iorio M, Nistala K, Pilkington CA, Wedderburn LR; Juvenile Dermatomyositis Research Group. Comparison of the Utility and Validity of Three Scoring Tools to Measure Skin Involvement in Patients With Juvenile Dermatomyositis. Arthritis Care Res (Hoboken). 2016 Oct;68(10):1514-21. doi: 10.1002/acr.22867. [Abstract Campanilho-Marques R, Almeida B, Deakin C, Arnold K, Gallot N, de Iorio M, Nistala K, Pilkington CA, Wedderburn LR; Juvenile Dermatomyositis Research Group. Comparison of the Utility and Validity of Three Scoring Tools to Measure Skin Involvement in Patients With Juvenile Dermatomyositis. Arthritis Care Res (Hoboken). 2016 Oct;68(10):1514-21. doi: 10.1002/acr.22867.]
  3. Ruperto N, Ravelli A, Pistorio A, Ferriani V, Calvo I, Ganser G, Brunner J, Dannecker G, Silva CA, Stanevicha V, Cate RT, van Suijlekom-Smit LW, Voygioyka O, Fischbach M, Foeldvari I, Hilario O, Modesto C, Saurenmann RK, Sauvain MJ, Scheibel I, Sommelet D, Tambic-Bukovac L, Barcellona R, Brik R, Ehl S, Jovanovic M, Rovensky J, Bagnasco F, Lovell DJ, Martini A; Paediatric Rheumatology International Trials Organisation (PRINTO); Pediatric Rheumatology Collaborative Study Group (PRCSG). The provisional Paediatric Rheumatology International Trials Organisation/American College of Rheumatology/European League Against Rheumatism Disease activity core set for the evaluation of response to therapy in juvenile dermatomyositis: a prospective validation study. Arthritis Rheum. 2008 Jan 15;59(1):4-13. doi: 10.1002/art.23248. [Abstract Ruperto N, Ravelli A, Pistorio A, Ferriani V, Calvo I, Ganser G, Brunner J, Dannecker G, Silva CA, Stanevicha V, Cate RT, van Suijlekom-Smit LW, Voygioyka O, Fischbach M, Foeldvari I, Hilario O, Modesto C, Saurenmann RK, Sauvain MJ, Scheibel I, Sommelet D, Tambic-Bukovac L, Barcellona R, Brik R, Ehl S, Jovanovic M, Rovensky J, Bagnasco F, Lovell DJ, Martini A; Paediatric Rheumatology International Trials Organisation (PRINTO); Pediatric Rheumatology Collaborative Study Group (PRCSG). The provisional Paediatric Rheumatology International Trials Organisation/American College of Rheumatology/European League Against Rheumatism Disease activity core set for the evaluation of response to therapy in juvenile dermatomyositis: a prospective validation study. Arthritis Rheum. 2008 Jan 15;59(1):4-13. doi: 10.1002/art.23248.]
  4. Bode RK, Klein-Gitelman MS, Miller ML, Lechman TS, Pachman LM. Disease activity score for children with juvenile dermatomyositis: reliability and validity evidence, Arthritis Rheum, 2003 Feb 15 49(1):7-15. [Pub Med Bode RK, Klein-Gitelman MS, Miller ML, Lechman TS, Pachman LM. Disease activity score for children with juvenile dermatomyositis: reliability and validity evidence, Arthritis Rheum, 2003 Feb 15 49(1):7-15.]

Cutaneous Dermatomyositis Disease Area and Severity Index (CDASI)

Description

The CDASI, developed by Dr. Victoria Werth and colleagues, is a clinician- scored single page instrument that separately measures activity and damage in the skin of dermatomyositis patients for use in clinical practice or clinical/therapeutic studies.  The modified CDASI (version 2) is the one in current use.  The modified CDASI has 3 activity measures (erythema, scale, and erosion/ulceration) and 2 damage measures (poikiloderma and calcinosis) which are assessed over 15 body areas. In addition, Gottron’s papules on the hands are evaluated both for activity and damage.  Lastly, the activity of periungual changes and alopecia is assessed.

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  • The "Cutaneous Dermatomyositis Area and Severity Index (CDASI)" is copyrighted by the University of Pennsylvania. For academic use, please contact Dr. Werth for permission ([email protected]). For commercial use, please contact Dr. Shilpa Bhansali for permission ([email protected]).

References

  1. Yassaee M, Fiorentino D, Okawa J, Taylor L, Coley C, Troxel AB, Werth VP. Modification of the cutaneous dermatomyositis disease area and severity index, an outcome instrument. Br J Dermatol. 2010 Mar;162(3):669-73. [PubMed Yassaee M, Fiorentino D, Okawa J, Taylor L, Coley C, Troxel AB, Werth VP. Modification of the cutaneous dermatomyositis disease area and severity index, an outcome instrument. Br J Dermatol. 2010 Mar;162(3):669-73.]
    This is a primary publication of this tool. Please seek permission to use from the publisher and authors.
     
  2. Anyanwu CO, Fiorentino D, Chung L, Dzuong C, Wang Y, Okawa J, Carr K, Propert KJ, Werth VP. Validation of the Cutaneous Dermatomyositis Disease Area and Severity Index (CDASI): characterizing disease severity and assessing responsiveness to clinical change. Br J Dermatol. Br J Dermatol. 2015 Oct;173(4):969-74. doi: 10.1111/bjd.13915 [Abstract Anyanwu CO, Fiorentino D, Chung L, Dzuong C, Wang Y, Okawa J, Carr K, Propert KJ, Werth VP. Validation of the Cutaneous Dermatomyositis Disease Area and Severity Index (CDASI): characterizing disease severity and assessing responsiveness to clinical change. Br J Dermatol. Br J Dermatol. 2015 Oct;173(4):969-74. doi: 10.1111/bjd.13915]
    This is a primary publication of this tool. Please seek permission to use from the publisher and authors.
     
  3. Ahmed S, Chakka S, Concha J, Krain R, Feng R, Werth VP. Evaluating important change in cutaneous disease activity as an efficacy measure for clinical trials in dermatomyositis. Br J Dermatol. 2020 Apr;182(4):949-954. doi: 10.1111/bjd.18223. Epub 2019 Sep 8. PMID: 31206600. [Abstract Ahmed S, Chakka S, Concha J, Krain R, Feng R, Werth VP. Evaluating important change in cutaneous disease activity as an efficacy measure for clinical trials in dermatomyositis. Br J Dermatol. 2020 Apr;182(4):949-954. doi: 10.1111/bjd.18223. Epub 2019 Sep 8. PMID: 31206600.]
  4. Ahmed S, Chen KL, Werth VP. The validity and utility of the Cutaneous Disease Area and Severity Index (CDASI) as a clinical outcome instrument in dermatomyositis: A comprehensive review. Semin Arthritis Rheum. 2020 Jun;50(3):458-462. doi: 10.1016/j.semarthrit.2020.01.002. PMID: 32057402. [Abstract Ahmed S, Chen KL, Werth VP. The validity and utility of the Cutaneous Disease Area and Severity Index (CDASI) as a clinical outcome instrument in dermatomyositis: A comprehensive review. Semin Arthritis Rheum. 2020 Jun;50(3):458-462. doi: 10.1016/j.semarthrit.2020.01.002. PMID: 32057402.]
  5. Tiao J, Feng R, Berger EM, Brandsema JF, Coughlin CC, Khan N, Kichula EA, Lerman MA, Lvovich S, McMahon PJ, Rider LG, Rubin AI, Scalzi LV, Smith DM, Taxter AJ, Treat JR, Williams RP, Yum SW, Okawa J, Werth VP. Evaluation of the reliability of the Cutaneous Dermatomyositis Disease Area and Severity Index and the Cutaneous Assessment Tool-Binary Method in juvenile dermatomyositis among paediatric dermatologists, rheumatologists and neurologists. Br J Dermatol. 2017 Oct;177(4):1086-1092. doi: 10.1111/bjd.15596. [Abstract Tiao J, Feng R, Berger EM, Brandsema JF, Coughlin CC, Khan N, Kichula EA, Lerman MA, Lvovich S, McMahon PJ, Rider LG, Rubin AI, Scalzi LV, Smith DM, Taxter AJ, Treat JR, Williams RP, Yum SW, Okawa J, Werth VP. Evaluation of the reliability of the Cutaneous Dermatomyositis Disease Area and Severity Index and the Cutaneous Assessment Tool-Binary Method in juvenile dermatomyositis among paediatric dermatologists, rheumatologists and neurologists. Br J Dermatol. 2017 Oct;177(4):1086-1092. doi: 10.1111/bjd.15596.] 
  6. Tiao J, Feng R, Bird S, Choi JK, Dunham J, George M, Gonzalez-Rivera TC, Kaufman JL, Khan N, Luo JJ, Micheletti R, Payne AS, Price R, Quinn C, Rubin AI, Sreih AG, Thomas P, Okawa J, Werth VP. The reliability of the Cutaneous Dermatomyositis Disease Area and Severity Index (CDASI) among dermatologists, rheumatologists and neurologists. Br J Dermatol. 2017 Feb;176(2):423-430. doi: 10.1111/bjd.15140. [Abstract Tiao J, Feng R, Bird S, Choi JK, Dunham J, George M, Gonzalez-Rivera TC, Kaufman JL, Khan N, Luo JJ, Micheletti R, Payne AS, Price R, Quinn C, Rubin AI, Sreih AG, Thomas P, Okawa J, Werth VP. The reliability of the Cutaneous Dermatomyositis Disease Area and Severity Index (CDASI) among dermatologists, rheumatologists and neurologists. Br J Dermatol. 2017 Feb;176(2):423-430. doi: 10.1111/bjd.15140.]
  7. Goreshi R, Okawa J, Rose M, Feng R, Lee LA, Hansen CB, Bangert CA, Connolly MK, Davis MD, Callen JP,. Fett NM, Fakharzadeh SS, Clarke JT, Werth VP.  Evaluation of reliability, validity, and responsiveness of the CDASI and the CAT-BM. J Invest Dermatol. 2012 Apr;132(4):1117-24. [PubMed Goreshi R, Okawa J, Rose M, Feng R, Lee LA, Hansen CB, Bangert CA, Connolly MK, Davis MD, Callen JP,. Fett NM, Fakharzadeh SS, Clarke JT, Werth VP.  Evaluation of reliability, validity, and responsiveness of the CDASI and the CAT-BM. J Invest Dermatol. 2012 Apr;132(4):1117-24.]
  8. Goreshi R, Chock M, Foering K, Feng R, Okawa J, Rose M, Fiorentino D, Werth V. Quality of life in dermatomyositis. J Am Acad Dermatol. 2011 Dec;65(6):1107-16. [PubMed Goreshi R, Chock M, Foering K, Feng R, Okawa J, Rose M, Fiorentino D, Werth V. Quality of life in dermatomyositis. J Am Acad Dermatol. 2011 Dec;65(6):1107-16.]
  9. Klein RQ, Bangert CA, Costner M, Connolly MK, Tanikawa A, Okawa J, Rose M, Fakharzadeh SS, Fiorentino D, Lee LA, Sontheimer RD, Taylor L, Troxel AB, Werth VP. Comparison of the reliability and validity of outcome instruments for cutaneous dermatomyositis. Br J Dermatol. 2008 Sep;159(4):887-94. [PubMed Klein RQ, Bangert CA, Costner M, Connolly MK, Tanikawa A, Okawa J, Rose M, Fakharzadeh SS, Fiorentino D, Lee LA, Sontheimer RD, Taylor L, Troxel AB, Werth VP. Comparison of the reliability and validity of outcome instruments for cutaneous dermatomyositis. Br J Dermatol. 2008 Sep;159(4):887-94.]

The Functional Index

Description

The Functional Index was developed as a functional outcome measure for patients with adult polymyositis or dermatomyositis to assess muscle endurance and function frequently affected muscle groups. Each muscle group is scored as the number of correctly performed repetitions with 60 or 120 maximal number of repetitions depending on muscle group. The Functional Index-2 (FI-2) was refined from the original Functional Index to eliminate five tasks due to ceiling effects and improve redundancy and rater-reliability. The FI-2 assesses muscle endurance in seven muscle groups, and can be performed on both right and left sides requiring a maximum of 33 minutes, or just on the dominant side which takes 21 minutes. The FI-3 shortens the tool further to include shoulder flexion with 1 kg weight cuff on the wrists, neck flexion/head lift, and hp flexion, performed bilaterally, allotting a maximum of 3 minutes per task to a maximal score for each item, taking a total of 15 minutes to complete. It has been validated as to content and construct validity and intra- and inter-rater reliability.

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References

  1. Ernste FC, Chong C, Crowson CS, Kermani TA, Mhuircheartaigh ON, Alexanderson H. Functional Index-3: A Valid and Reliable Functional Outcome Assessment Measure in Dermatomyositis and Polymyositis Patients. J Rheumatol. 2020 Apr 15:jrheum.191374. doi: 10.3899/jrheum.191374. PMID: 32295854. [Abstract Ernste FC, Chong C, Crowson CS, Kermani TA, Mhuircheartaigh ON, Alexanderson H. Functional Index-3: A Valid and Reliable Functional Outcome Assessment Measure in Dermatomyositis and Polymyositis Patients. J Rheumatol. 2020 Apr 15:jrheum.191374. doi: 10.3899/jrheum.191374. PMID: 32295854.]
    This is a primary publication of the Functional Index-3. Please seek permission to use from the publisher and authors.
     
  2. Alexanderson H, Broman L, Tollbäck A, Lundberg IE, Stenström CH. Functional Index-2: validity and reliability of a disease-specific measure of impairment in patients with polymyositis and dermatomyositis. Arthritis Rheum (Arthritis Care Res), 2006;55:114-22. [Pub Med Alexanderson H, Broman L, Tollbäck A, Lundberg IE, Stenström CH. Functional Index-2: validity and reliability of a disease-specific measure of impairment in patients with polymyositis and dermatomyositis. Arthritis Rheum (Arthritis Care Res), 2006;55:114-22.]
    This is a primary publication of the Functional Index-2. Please seek permission to use from the publisher and authors.
     
  3. Josefson A, Romanus E, Carlsson J. A functional index in myositis. J Rheumatol, 1996;23:1380-4. [Pub Med Josefson A, Romanus E, Carlsson J. A functional index in myositis. J Rheumatol, 1996;23:1380-4.]
    This is a primary publication of the Functional Index. Please seek permission to use from the publisher and authors.
     
  4. Borg GA. Psychophysical bases of perceived exertion. Med Sci Sports Exerc, 1982;14:377-81. [Pub Med Borg GA. Psychophysical bases of perceived exertion. Med Sci Sports Exerc, 1982;14:377-81.]

Semi-open Muscle Biopsy Technique Using a Conchotome

Description

The semi-open muscle biopsy technique or percutaneous conchotome technique was developed in Scandinavia (Henriksson KG, 1979) and has been adopted as a routine biopsy method in many rheumatology and neurology centers, particularly in Northern Europe. It gives a good yield of muscle tissue for routine histopathology, immunohistochemistry staining and for biochemistry analyses as well as for research on muscle tissue (Dorph C et al 2001).

Video: Conchotome Assisted Muscle Biopsy or Minimally Invasive Muscle Biopsy or Semi-open Muscle Biopsy
Video Credit: Maryam Dastmalchi, M.D., Ph.D., Lesley Ann Saketkoo, M.D., M.P.H.

Video: Percutaneous Tibialis Anterior Muscle Biopsy Using Single-use Conchotome Forceps
Video Credit: James Lilleker, MB BCh, Ph.D.

For questions, please contact:
Ingrid Lundberg M.D., Ph.D., Professor, [email protected]
Maryam Dastmalchi, M.D., Ph.D., Consultant,
Rheumatology Unit, Karolinska University Hospital and Karolinska Institutet Stockholm, Sweden, [email protected]
Lesley Ann Saketkoo, M.D., M.P.H., Associate Professor of Medicine, Tulane University, [email protected]

References

  1. Dorph C, Nennesmo I, Lundberg IE. Percutaneous conchotome muscle biopsy. A useful diagnostic and assessment tool J. Rheumatol, 2001;28:1591-9. [Abstract Dorph C, Nennesmo I, Lundberg IE. Percutaneous conchotome muscle biopsy. A useful diagnostic and assessment tool J. Rheumatol, 2001;28:1591-9.]
  2. Henriksson KG. "Semi-open" muscle biopsy technique. A simple outpatient procedure. Acta Neurol Scand, 1979;59:317-23. [Abstract Henriksson KG. "Semi-open" muscle biopsy technique. A simple outpatient procedure. Acta Neurol Scand, 1979;59:317-23.]