Inclusion body myositis: A difficult diagnosis in elderly people

Nclusion body myositis (IBM) is the most common inflammatory myopathy in patients older than 50 years, however, it is very rare amongst the inflammatory myopathies. It is characterised by slowly progressive, disabling muscle weakness and inclusion bodies visible on muscle biopsy. Due to the slow progression of the disease, histologic similarity with other myopathies and limited awareness of physicians, the diagnosis is frequently delayed or it is misdiagnosed as polymyositis. Furthermore, the co-morbidities of older people may render clinical diagnosis difficult. IBM should be a diagnostic consideration in the evaluation of progressive weakness in older patients. A high index of suspicion along with knowledge of the diagnostic criteria is essential to avoid misdiagnosis. In this article, we report a 63 year old man diagnosed with IBM 5 years after the initial presentation and review the literature.