{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,9]],"date-time":"2025-11-09T03:34:20Z","timestamp":1762659260500,"version":"build-2065373602"},"reference-count":13,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2013,9,24]],"date-time":"2013-09-24T00:00:00Z","timestamp":1379980800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Arthritis Care &amp; Research"],"published-print":{"date-parts":[[2013,10]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To test 4\u2010year\u2010olds, using 14 maneuvers of the Childhood Myositis Assessment Scale (CMAS), comparing healthy children with those with juvenile dermatomyositis (DM).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Healthy 4\u2010year\u2010olds (n = 28) completed the CMAS. Their scores were compared with children with juvenile DM (n = 18) who had a muscle Disease Activity Score (DAS\u2010M) of 0.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The healthy children achieved a mean \u00b1 SD CMAS score of 46.6 \u00b1 2.3 (interquartile range 46\u201347). There were no significant differences between boys and girls, and the scores were not significantly associated with height or weight. The greatest variation involved items that assessed endurance. Item 1, neck raise, yielded a mean \u00b1 SD score of 28.2 \u00b1 19.3 seconds, with a mean \u00b1 SD CMAS score of 2.5 \u00b1 0.9 (maximum score 5). Item 3, leg lift, yielded a mean \u00b1 SD score of 55.5 \u00b1 37.3 seconds, with a mean \u00b1 SD CMAS score of 3.1 \u00b1 1.1 (maximum score 5). Item 5, sit\u2010ups maneuver, yielded a mean \u00b1 SD score of 5.3 \u00b1 1.1 sit\u2010ups. Almost identical data were obtained for the 18 treated children with juvenile DM who had normal strength on the DAS\u2010M.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Healthy children ages 4 years do not achieve the total CMAS score of 52 attained by older children. Both boys and girls were remarkably consistent, with a mean CMAS score of 46.6. Children ages 4 years with juvenile DM with a DAS\u2010M of 0 also achieved a CMAS score of 46.6. We conclude that half of 4\u2010year\u2010old children achieve a mean CMAS score of 46 or 47, not a total CMAS score of 52, suggesting that weakness may be overdiagnosed in 4\u2010year\u2010olds with an inflammatory myopathy.<\/jats:p><\/jats:sec>","DOI":"10.1002\/acr.22041","type":"journal-article","created":{"date-parts":[[2013,5,10]],"date-time":"2013-05-10T16:19:11Z","timestamp":1368202751000},"page":"1697-1701","source":"Crossref","is-referenced-by-count":19,"title":["Lack of Achievement of a Full Score on the Childhood Myositis Assessment Scale by Healthy Four\u2010Year\u2010Olds and Those Recovering From Juvenile Dermatomyositis"],"prefix":"10.1002","volume":"65","author":[{"given":"Rebecca","family":"Qui\u00f1ones","sequence":"first","affiliation":[{"name":"Ann &amp; Robert H. Lurie Children's Hospital of Chicago Chicago Illinois"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gabrielle A.","family":"Morgan","sequence":"additional","affiliation":[{"name":"Ann &amp; Robert H. Lurie Children's Hospital of Chicago Chicago Illinois"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria","family":"Amoruso","sequence":"additional","affiliation":[{"name":"Ann &amp; Robert H. Lurie Children's Hospital of Chicago Chicago Illinois"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Regina","family":"Field","sequence":"additional","affiliation":[{"name":"Ann &amp; Robert H. Lurie Children's Hospital of Chicago Chicago Illinois"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chiang\u2010Ching","family":"Huang","sequence":"additional","affiliation":[{"name":"Feinberg School of Medicine, Northwestern University Chicago Illinois"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lauren M.","family":"Pachman","sequence":"additional","affiliation":[{"name":"Ann &amp; Robert H. Lurie Children's Hospital of Chicago and Feinberg School of Medicine, Northwestern University Chicago Illinois"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2013,9,24]]},"reference":[{"key":"e_1_2_6_2_1","first-page":"1198","article-title":"Juvenile dermatomyositis at diagnosis: clinical characteristics of 79 children","volume":"25","author":"Pachman LM","year":"1998","journal-title":"J Rheumatol"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.21068"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/1529-0131(199910)42:10<2213::AID-ANR25>3.0.CO;2-8"},{"key":"e_1_2_6_5_1","first-page":"93","volume-title":"Muscle strength","author":"Hinderer KA","year":"1993"},{"key":"e_1_2_6_6_1","first-page":"1106","article-title":"Validation of the Childhood Health Assessment Questionnaire in the juvenile idiopathic myopathies","volume":"28","author":"Huber AM","year":"2001","journal-title":"J Rheumatol"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.20397"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.20179"},{"key":"e_1_2_6_9_1","unstructured":"Standardized method for performing the Childhood Myositis Assessment Scale.2009. 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