The assessment of disease activity and damage in patients with idiopathic inflammatory myositis remains inadequate. In this review we describe current approaches to the assessment of disease activity and damage. These include serologic, biochemical, radiographic, and histologic approaches. None of these methods are individually effective in differentiating disease activity from damage. Invariably combinations of these methods are needed to comprehensively assess the extent of both muscular and extramuscular disease. Recent developments (in serology, imaging, and genetics) are mentioned. These may prove to be useful in assessing the full extent of idiopathic inflammatory myositis; however, they are not widely available at present and are confined to research studies
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