The Evolving Role of Muscle and Nerve Biopsies in Neuromuscular Diagnosis: A Discussion With Experts

In this AANEM podcast, Dr. Andrés De León interviews neuromuscular pathology experts Dr. Aziz Shaibani and Dr. Marcus Pinto about the current state and value of muscle and nerve biopsies in clinical practice. The discussion covers essential topics including proper indications for biopsies, technical considerations in choosing biopsy sites, staining techniques, and the impact of advancing genetic testing on diagnostic approaches. Dr. Shaibani emphasizes that while genetic testing has reduced some muscle biopsy indications, biopsies remain crucial for certain conditions like inflammatory myopathies and mitochondrial disorders. Dr. Pinto details specific scenarios where nerve biopsies are invaluable, particularly in diagnosing vasculitic neuropathy and amyloidosis. Both experts share insights on the complementary role of muscle and nerve biopsies in conditions like systemic vasculitis and discuss how modern diagnostic tools like myositis antibody testing and genetic panels are changing but not eliminating the need for tissue diagnosis.