Overview
Lingual myositis refers to inflammation of the intrinsic muscles of the tongue, often associated with autoimmune conditions or trauma. 12Diagnosis
Clinical presentation includes tongue swelling, pain, and dysphagia or speech difficulties.
Imaging (e.g., MRI) can help identify muscle inflammation and rule out other causes.
Electromyography (EMG) may show myopathic changes indicative of muscle inflammation.
Biopsy may be necessary for definitive diagnosis, especially to exclude malignancy in autoimmune myositis patients. 1Management
First-line treatments: Corticosteroids (e.g., prednisone) to reduce inflammation. 1
Adjunctive therapies: Immunosuppressive agents such as methotrexate or intravenous immunoglobulin (IVIG) for refractory cases.
Supportive care: Speech therapy and nutritional support if dysphagia is significant.Special Populations
Autoimmune myositis: Routine malignancy screening recommended by some practitioners despite lack of consensus. 1
Trauma-induced cases: Management focuses on trauma specifics; genioplasty-related cases may require surgical intervention alongside medical management. 2Key Recommendations
Perform routine malignancy screening in newly diagnosed autoimmune myositis patients due to increased risk, though evidence is insufficient for a definitive guideline. (Evidence: Moderate) 1
Corticosteroids should be considered first-line therapy for managing inflammatory symptoms in lingual myositis. (Evidence: Expert opinion) 1
Consider imaging (MRI) and EMG for diagnostic confirmation and to differentiate from other causes of tongue pathology. (Evidence: Moderate) 1References
1 Dutton K, Soden M. Malignancy screening in autoimmune myositis among Australian rheumatologists. Internal medicine journal 2017. link
2 Mulherin D, Schow CE. Traumatic myositis ossificans after genioplasty. Journal of oral surgery (American Dental Association : 1965) 1980. link