Copyright © Lippincott Williams & Wilkins. Unauthorized reproduction of this article is prohibited. EDITORIAL REVIEW Neurologists are from Mars. Rheumatologists are from Venus: differences in approach to classifying the idiopathic inflammatory myopathies Lisa Christopher-Stine Introduction Men are from Mars, Women are from Venus, the popular book by John Gray, suggests by its title, that men and women are as different as beings from other planets. It offers helpful suggestions for improving men–women relation- ships by understanding the communication style of the opposite gender. This metaphor can be applied to neuro- logists and rheumatologists in the way that we may speak similar, yet different languages when describing the same myositis patients. Specifically of interest here are those with the recently described autoimmune necrotizing myopathy subtype. Working in parallel It has been my experience over the past several years working in a multidisciplinary clinic with various sub- specialists – with the exclusive focus of treating patients with idiopathic inflammatory myopathies (‘myositis’) and their clinical mimics – that we may, in fact, not always be practicing synergistically but rather working in parallel. To what do we owe this communication gap? Why do we not always speak the same language? As a rheumatologist, I have ascertained a great deal of knowledge from my neurology colleagues by observation and discussion working side by side in the clinical and research settings. Johns Hopkins University, Baltimore, Maryland, USA Correspondence to Lisa Christopher-Stine, MD, MPH, Johns Hopkins Bayview Medical Center, Johns Hopkins Myositis Center, Mason F. Lord Building Center Tower, Suite 4100, Baltimore, MD 21224, USA Tel: +1 410 550 6962; fax: +1 410 550 3542; e-mail: lcs@jhmi.edu Current Opinion in Rheumatology 2010, 22:623–626 Purpose of review Inflammatory myopathy (IIM) classification criteria have been the source of considerable debate. In the three decades since Bohan and Peter published their criteria which have long stood as the gold standard for diagnosis in clinical practice as well as inclusion into clinical trials, more sophisticated understanding of immunopathogenesis, histology, and specific autoantibody associations has broadened our understanding of these diseases. This editorial review examines the diverse approaches between different subspecialists in deriving appropriate IIM classification utilizing this updated knowledge. Recent findings Several investigators have proposed improved IIM classification criteria. More recently, larger scale consensus efforts have been undertaken by various expert groups including the European Neuromuscular Centre (ENMC) and The International Myositis Assessment and Clinical Studies Group (IMACS). The intent is to refine the classification criteria utilizing our enhanced understanding which has matured since the original publication of Bohan and Peter’s proposal in 1975. Summary Many diagnostic/classification criteria have been proposed for different forms of IIM over the last three decades. The majority of these have been based on clinical impressions rather than rigorous data analyses or expert consensus and none has been fully tested for sensitivity or specificity using appropriately powered studies that take into account relevant disease confounders. Different sets of criteria proposed and adopted by different specialties hamper the ability to compare clinical studies and assess clinical trials’ outcomes. Large, multicentered, multispecialty studies are required to develop improved IIM criteria. Keywords autoimmune necrotizing myopathy, Bohan and Peter, myositis, myositis classification criteria, polymyositis Curr Opin Rheumatol 22:623–626 ß 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins 1040-8711 1040-8711 ß 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins DOI:10.1097/BOR.0b013e32833f8f72