{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T04:57:05Z","timestamp":1784869025942,"version":"3.55.0"},"reference-count":18,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2021,8,3]],"date-time":"2021-08-03T00:00:00Z","timestamp":1627948800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Muscle and Nerve"],"published-print":{"date-parts":[[2021,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction\/Aims<\/jats:title><jats:p>Anti\u20133\u2010hydroxy\u20103\u2010methyl\u2010glutaryl\u2010coenzyme A reductase (HMGCR) myopathy is a rare but serious complication of statin use. The aim of this study was to describe the imaging features of statin\u2010associated anti\u2010HMGCR myopathy on thigh muscle magnetic resonance imaging (MRI).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Thigh muscle MRI images of six patients with statin\u2010associated anti\u2010HMGCR myopathy were reviewed for muscle edema, fatty replacement, and fascial edema in four compartments of each thigh: gluteal, anterior, medial, and posterior. Signal intensity ratio (SIR) was calculated in 17 muscles in both thighs on T2\u2010weighted fat\u2010suppressed images. Intracompartmental comparison of T2 SIRs of different muscles were performed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>All patients demonstrated bilateral symmetrical pan\u2010compartmental muscle edema. Three patients had fatty infiltration, involving gluteal and\/or posterior compartments. In the anterior compartment, rectus femoris and vastus lateralis most frequently demonstrated the highest T2 SIR. In the posterior compartment, semimembranosus most frequently demonstrated the highest T2 SIR. The long head of the biceps femoris always had a higher T2 SIR than the short head.<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion<\/jats:title><jats:p>Statin\u2010associated anti\u2010HMGCR myopathy commonly demonstrates bilateral symmetrical pan\u2010compartmental edema on thigh muscle MRI, with anterolateral predilection in the anterior compartment, and greater involvement of the semimembranosus with relative sparing of the short head of the biceps femoris in the posterior compartment. These observations can contribute to the diagnosis of statin\u2010associated anti\u2010HMGCR myopathy.<\/jats:p><\/jats:sec>","DOI":"10.1002\/mus.27382","type":"journal-article","created":{"date-parts":[[2021,7,23]],"date-time":"2021-07-23T14:29:50Z","timestamp":1627050590000},"page":"500-504","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Statin\u2010associated anti\u20133\u2010hydroxy\u20103\u2010methyl\u2010glutaryl\u2010coenzyme A reductase (HMGCR) myopathy: Imaging findings on thigh\u2010muscle magnetic resonance imaging (MRI) in six patients"],"prefix":"10.1002","volume":"64","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1641-7180","authenticated-orcid":false,"given":"Kam\u2010Ho","family":"Lee","sequence":"first","affiliation":[{"name":"Department of Radiology Queen Mary Hospital  Hong Kong"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuan","family":"Gao","sequence":"additional","affiliation":[{"name":"Division of Neurology, Department of Medicine Queen Mary Hospital, The University of Hong Kong  Hong Kong"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vince","family":"Lau","sequence":"additional","affiliation":[{"name":"Department of Radiology Queen Mary Hospital  Hong Kong"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,8,3]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra1515161"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/mus.24642"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.nmd.2017.09.016"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.semarthrit.2020.02.009"},{"key":"e_1_2_9_6_1","first-page":"1","article-title":"Ultrasound\u2010MRI fusion for targeted biopsy of myopathies","volume":"26","author":"Lee KH","year":"2019","journal-title":"AJR Am J Roentgenol."},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/mus.24307"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0181069"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0960-8966(02)00023-8"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1212\/NXI.0000000000000523"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jocn.2018.08.010"},{"key":"e_1_2_9_12_1","first-page":"257","article-title":"Immune\u2010mediated necrotizing myopathy due to statins exposure","volume":"37","author":"Villa L","year":"2018","journal-title":"Acta Myol."},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2016-210198"},{"key":"e_1_2_9_14_1","doi-asserted-by":"crossref","DOI":"10.1136\/rmdopen-2018-000850","article-title":"MRI of skeletal muscles in patients with idiopathic inflammatory myopathies: characteristic findings and diagnostic performance in dermatomyositis","volume":"5","author":"Kichi T","year":"2019","journal-title":"RMD Open."},{"key":"e_1_2_9_15_1","first-page":"1693","article-title":"Magnetic resonance imaging in the idiopathic inflammatory myopathies","volume":"18","author":"Fraser DD","year":"1991","journal-title":"J Rheumatol."},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF00868438"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.2214\/AJR.17.17849"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41584-020-00515-9"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/keu422"}],"container-title":["Muscle &amp; 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