Myositis refers to a group of rare autoimmune diseases in which the immune system attacks and inflames muscle tissue, causing progressive weakness. The two main types seen in rheumatology practice are polymyositis (muscle involvement only) and dermatomyositis (muscle plus distinctive skin changes).

• Weakness typically affects the muscles closest to the trunk — shoulders, hips and thighs — making it hard to climb stairs, rise from a chair or lift the arms overhead.
• Dermatomyositis has telltale skin findings: a violet-purple rash on the eyelids (heliotrope rash) and scaly bumps over the knuckles (Gottron’s papules).
• Myositis can sometimes affect other organs, including the lungs (interstitial lung disease) and the heart, and in adults it occasionally accompanies an underlying malignancy — which is why a thorough work-up matters.
• With early diagnosis and the right immunosuppressive treatment, most patients regain significant strength and function.

• Progressive weakness in the shoulders, hips and thighs — difficulty climbing stairs, standing from a low chair, or combing hair
• Muscle pain or tenderness in some patients, though weakness is usually more prominent than pain
• In dermatomyositis: a violet rash on the eyelids, a red rash across the face/chest (“V-sign”), and scaly bumps over the knuckles
• Fatigue, difficulty swallowing in more advanced disease, and sometimes shortness of breath if the lungs are involved
• Difficulty lifting the head off the pillow, or getting up from lying down without using the arms

• The exact trigger is unknown, but myositis is an autoimmune disease — the immune system mistakenly attacks the body’s own muscle (and in dermatomyositis, skin) tissue.
• A combination of genetic susceptibility and environmental triggers, including certain viral infections and ultraviolet light exposure, is thought to play a role.
• In some adults, dermatomyositis can be associated with an underlying cancer, which is why age-appropriate cancer screening is an important part of the work-up.
• It can occur alone, or alongside other autoimmune conditions such as lupus or scleroderma (an overlap syndrome).

• Clinical examination assessing the pattern of muscle weakness and any characteristic skin findings.
• Blood tests for muscle enzymes, especially creatine kinase (CK), which is usually markedly elevated, along with autoantibody testing (myositis-specific antibodies).
• Electromyography (EMG) to confirm a pattern of muscle, rather than nerve, involvement.
• MRI of the affected muscles to map inflammation and guide biopsy, and often a muscle biopsy to confirm the diagnosis definitively.
• Screening for lung involvement (pulmonary function tests, CT chest) and, in adults with dermatomyositis, age-appropriate cancer screening.

Corticosteroids to control inflammation

Treatment usually starts with a moderate-to-high dose of corticosteroids to bring the immune attack on muscle under control, followed by a gradual, supervised taper.

Steroid-sparing immunosuppressants

Because long-term high-dose steroids carry side effects, a second immunosuppressive medicine — such as methotrexate, azathioprine or mycophenolate — is usually added to maintain control and allow the steroid dose to come down.

Physiotherapy and rehabilitation

A structured, supervised exercise programme helps rebuild muscle strength safely once the acute inflammation is controlled — our physiotherapy team works alongside your rheumatologist throughout treatment.

Skin, lung and heart monitoring

For dermatomyositis, we also manage the skin disease directly (sun protection and topical or systemic treatment), and monitor lung and heart involvement regularly since these can drive long-term outlook.

Consultations with the OARC rheumatology team run Monday to Saturday, 9:00 AM–2:00 PM and 4:30–9:00 PM. Call +91 93386 53086 or book online.

• With early diagnosis and consistent treatment, most patients regain substantial muscle strength and return to normal daily activities.
• Myositis is a long-term condition that needs sustained rheumatology follow-up, even after symptoms improve, to prevent relapse and monitor for lung, heart or other organ involvement.
• Because dermatomyositis can occasionally be linked to an underlying cancer in adults, ongoing age-appropriate screening is part of long-term care.