Idiopathic Inflammatory Myopathy Mimics in Children: Pearls and Challenges.

Idiopathic inflammatory myopathies represent a group of acquired and treatable myopathies characterized by distinct clinical features that should be distinguished from other neuromuscular diseases presenting with proximal muscle weakness or serum creatine kinase elevation. The approach to neuromuscular disorders requires a comprehensive evaluation of history and clinical phenotype. Depending on the presentation, diagnostic strategies vary from basic laboratory tests to complementary electrophysiological studies, muscle imaging, histopathology, and genomic tests. Since the approach to individualized treatments varies according to the accurate diagnosis, a close collaboration between pediatric neurologists and rheumatologists is crucial for the management and follow-up. This review aims to provide a structured diagnostic approach to pediatric myositis mimics, emphasizing the importance of accurate differential diagnosis and highlighting frequently overlooked conditions to improve clinical outcomes.