Arthritis & Rheumatism, Volume 63,
November 2011 Abstract Supplement

Abstracts of the American College of
Rheumatology/Association of Rheumatology Health Professionals
Annual Scientific Meeting
Chicago, Illinois November 4-9, 2011.

The Childhood Myositis Assessment Scale (CMAS) Total Score in Healthy Children, Age 45 Years, is 46, Not 52.

Quinones1,  Rebecca, Morgan1,  Gabrielle, Amoruso1,  Maria, Wang2,  Deli, Pachman3,  Lauren M.

Children's Memorial Hospital, Chicago, IL
Northwestern University's Feinberg School of Medicine, Chicago, IL
Northwestern University Feinberg School of Medicine, Chicago, IL


JDM is a systemic vasculopathy primarily affecting the neck flexors and proximal muscles of both the upper and lower extremities, as well as the child's core strength. Previous national epidemiology studies have documented that the mean age diagnosis is 6.7 years (boys, girls) but 25% are age 4 or less at the time of their first visit to the physician. We had observed that treated children with JDM who had achieved a disease activity score for muscle weakness of "0", still had an average CMAS score of 46, raising the question: "Could healthy children, age 4–5, ever achieve a CMAS score of 52?" Hypothesis: The "normal" total value for CMAS of 52 is not attainable by healthy children who are 4–5 years of age.


To evaluate healthy boy and girls, age 4.0–4.9 years of age, the validated CMAS 14 point scale was used. The CMAS was administered by the same evaluator, who had been trained in the CMAS administration. The study is descriptive and Spearman rank correlation coefficient was used for age comparisons and Mann-Whitney for comparisons of items by gender.


The test population of 28 healthy children was recruited after obtaining IRB approved consent (IRB#2010–14188). The group was composed of 14 boys and 14 girls, age 4.0–4.9 years. Their mean age was 4.4 years +/-0.3 years. The racial composition was: 68% White/Hispanic, 32% non-White, non-Hispanic. As a group, they achieved a total mean CMAS score of 46.6 ± 2.3 SD. There were no significant differences between boys and girls, and their scores were unaffected by their height or weight. The greatest variation in the scores involved those that were effort dependent. Item 1, neck raise score yielded a mean of 28.12 seconds ± 19.17 SD, CMAS score=2.5 ± 0.9/5. For item 3, the leg lift score =55.27± 36.94 SD seconds; CMAS score=3.1, ± 1.1/5. Finally, item 8, arm raise score=57.73 ± 6.53 seconds, CMAS score3.8 ±0.4/4. The remainder of the CMAS items were very consistent between the boys and the girls.


Healthy children age 4–5 are not able to achieve a total CMAS of 52, expected of older children. In fact, children of this age, both boys and girls were remarkable consistent, both performing at a CMAS mean level of 46. These data suggest that young children with JDM, who are between 4–5 years of age and who reach a score of 46, are in fact performing in a normal fashion, and should not be considered to be impaired.

Supported solely by CureJM.

To cite this abstract, please use the following information:
Quinones, Rebecca, Morgan, Gabrielle, Amoruso, Maria, Wang, Deli, Pachman, Lauren M.; The Childhood Myositis Assessment Scale (CMAS) Total Score in Healthy Children, Age 45 Years, is 46, Not 52. [abstract]. Arthritis Rheum 2011;63 Suppl 10 :2007

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