I was diagnosed with PM withough a muscle biopsy. They ran a whole whack of blood work, most of which was sent to another city for processing and the results came back PM. She wanted to spare me the muscle biopsy if she could and she did. I hear they hurt! And...I am a suck I guess :)

I got diagnosed with PM thru a blood test, after having a muscle biopsy my diagnosis was changed to DM, I don't have the rash with it though. I also have vasculitis which was diagnosed thru then biopsy as well.

I have DM and I had the classic rash etc. Then the doctor was just stuck between was this lupus or was this DM. They were 99% sure I had DM but just to be sure they did a biopsy which showed DM. I don't think a biopsy is always necessary, but my DM wasn't responding to treatment as fast as they thought it should

Don't believe biospys are absolutely necessary. There are some blood markers, that if positive can point you in the right direction.

Way back when I was diagnosed (1986), biopsy was the gold standard; didn't have those test back then.

Have since had most and all positive.

Great :0)

I was almost bed-ridden by the time I saw the neurologist, and was told I probably had PM. Then they did an EMG to rule out MS and ALS. This test verified myositis. I wouldn't agree to a muscle biopsy until I fell and broke my leg, at which time I had to have surgery anyway to insert a plate and repair my knee. However, the biopsy just verified myositis, but not which one. Again the doctors decided that it was PM rather than DM because of other indicators. Now my skin biopsy last week said DM with overlapping lupus. The dermatologist told me PM with overlapping DM and lupus. So go figure!

One of the reasons I didn't agree to the muscle biopsy at first was because I had done research online and found testimonials from many people who had 2 or 3 muscle biopsies that kept coming back inconclusive. I knew that whichever I had (PM or DM) was debilitating, but that I was responding to Prednisone, so I didn't want to go through the discomfort, or run the risk of flairing the PM even more. But that's just me.

You've got to make the decision based on what you and your doctor are comfortable with. I will say a prayer that you make the right decision.

I was diagnosed without a muscle biopsy. Mine is a little different in that I had a lung biopsy since I had "organizing pneumonia" and they wanted to confirm the diagnosis. After that, they sent me to my rheumy who thought my blood work/markers were fine to diagnose PM/ISL and didn't think I needed a muscle biopsy due to the blood tests. Hope that helps :-)

I just thought I would ask out of curiosity, believe me i'm happy they didn't. I just didn't know how often they just went off blood tests. The blood tests and just my overall appearance are all my rheumatologist have went off of for diagnosis/treatment. Any further look into my health have been done on ER trips.

From what I have learned (personally & thru research) muscle biopsy is the last resort in diagnosing PM, mostly in differentiating PM and IBM (Inclusion Body Myositis). PM is deemed treatable but IBM not.

I had an inconclusive muscle biopsy and it was the worst procedure I've had (as far as recovering from it). Part of the problem, though, was I was on blood thinners at the time and I had huge hematomas in my leg as a result of the biopsy. Since then another biopsy was discussed but the blood tests and my muscle weakness (plus my response to Prednisone) made my diagnosis pretty conclusive so my doctors agreed it was not necessary to repeat the biopsy since it would affect how they treated me anyway.

I was diagnosed at Mayo Clinic with a skin biopsy. They said my symptoms were so classic that a skin biopsy would suffice and it did. The Dr said she felt comfortable making the diagnoses without any biopsy at all but felt it would be prudent to at least do a skin biopsy.

I have just recently been diagnosed with mixed connective tissue disease - polymyosotis without a biopsy. I'm having a muscle biopsy tomorrow. My doctor did an indepth history of my symptons and a physical test. My bloodwork came back really high in the enzymes and she called that day and said we need to put you on medication right away. I'm currently on 50 mg prednisone and 100 mg Imuran and it has been two weeks. I'm feeling pretty good and do not have very many side effects. The biopsy will confirm the doctor's diagnosis. I'm also having an EMG and have had an ECG as well.

Any more news on your diagnosis?

Ideally, the muscle biopsy should be done prior to medication which might skew the results. The biopsy should be not done on the same muscle as the one used in the EMG and ideally, it should target the other side of the body. The vastus lateralis of the quadriceps is usually the site of choice (side muscle of upper thigh). Personally, I chose the left deltoid (upper arm) because I used it less than my legs or my right arm so it would less painful. The analysis and interpretation by the pathologist is critical in the diagnosis.
Good luck!

I was pretty much diagnosed w/o the biopsy...but they did it anyway so that I would have a complete work up. It really wasn't that big of a deal for me. I had it in my L deltoid though...not my quads.

Bloodwork and symptoms are the real indicators...

hope you do well!!