Learning Radiology xray montage


  • Along with polymyositis, part of a group of idiopathic inflammatory myopathies with both cutaneous and visceral manifestations
    • Affects the esophagus, lungs and heart
  • Damaged chondroitin sulfate, atrophy of muscles, followed by calcification of muscle and subcutaneous tissue
  • Most believe dermatomyositis is closely related to polymyositis although the pathogenesis of the two remain controversial
  • Occur at age 5-10 and again in 50’s, dermatomyositis being the only one of the two diseases seen in children
  • More common in females
    • Linear and confluent calcifications in soft tissues of extremities
    • Acro-osteolysis
    • Chest-may have infiltrates associated, especially from aspiration

  • Clinically

    • Dysphagia
    • Erythematous purple-red rash of eyelids, trunk and hands (seen in dermatomyositis)
      • May be sole manifestation in up to 40% of patients with disease
    • Painless, symmetric, proximal muscle weakness
  • Associated with a higher incidence of malignancies of GI tract, lung, ovary , breast, kidney in adults, not usually children

  • Imaging

  • MRI may show an inflammatory myopathy
  • Calcinosis universalis in dermatomyositis
    • Diffuse cutaneous, subcutaneous and sometimes muscular calcification
    • Usually affects children and young adults
    • Not actual bone formation
    • More linear than calcifications in scleroderma, which tend to be punctate (calcinosis circumscripta)
    • Calcium-channel blockers have been reported to help in some cases of calcinosis





Dermatomyositis. Sheet-like calcifications seen in patients with
dermatomyositis is called calcinosis universalis because of its wide-spread distribution.
This is more likely to occur in younger patients with dermatomyositis.




Dermatomyositis. Multiple calcifications are seen in the subcutaneous tissue
on this cross-sectional CT scan of the abdomen in a patient with dermatomyositis.


  • May resemble myositis ossificans progressiva
    • Myositis ossificans progressive (fibrodyplasia ossificans progressiva)
      • Begins with subcutaneous, painful masses in neck
        • Progresses down back over shoulders, chest, abdomen
      • Rounded or linear calcification starting in neck
      • More clumplike in places than  calcinosis universalis
      • Ossification of voluntary muscles

  • Treatment

    • Prednisone
    • Cytotoxic agents like methotrexate
  • Prognosis depends on age, and cardiac, pulmonary or esophageal involvement
    • Spontaneous remission has been reported in up to 1/5 of cases