Download PDFPDF Letter Muscle tissue oxygenation as a functional tool in the follow up of dermatomyositis Free M C P van Beekvelt1, R A Wevers1, B G M van Engelen1, W N J M Colier2 Author affiliations http://dx.doi.org/10.1136/jnnp.73.1.93 Request Permissions Near-infrared spectroscopy (NIRS) is a direct, non-invasive optical method for measuring local oxygenation and haemodynamics in muscle tissue. Although measurement of local oxygenation by NIRS has been used for the diagnosis of metabolic myopathies, the technique has not previously been applied to inflammatory myopathies. Dermatomyositis is a muscle disorder characterised by complement mediated capillary necrosis, resulting in ischaemia and hypoperfusion. We have now employed NIRS to study the effect of corticosteroid treatment on haemodynamics in muscle tissue in dermatomyositis. The pathological features of dermatomyositis are characterised by a decreased number of capillaries per muscle fibre and necrosis of single muscle fibres or clusters of fibres at the periphery of the fasciculi.1 Muscle fibre regeneration and an increased number of capillaries have been shown in dermatomyositis after intravenous immune globulin treatment,2 but corticosteroids are still considered to be the first line of therapy. In the clinical setting, the effect of treatment is mainly assessed by muscle strength and creatine kinase (CK) levels. Direct measurement of capillary and muscle fibre status can only be done by repeated muscle biopsies. However, apart from the fact that muscle biopsies are invasive, they are also a static representation of muscle tissue at a fixed time point and at a particular location (selection bias).