Introduction
Muscle biopsy is an essential diagnostic procedure in the investigation of the diagnosis of myopathy \cite{Dastmalchi_2010}.
The cohort of patients undergoing this procedure often have multiple co-morbidities, posing a significant anaesthetic risk and requiring that the muscle biopsy procedure is performed under general anaesthesia which infers additional clinical risk. Furthermore muscle biopsies for the diagnosis of neuromuscular pathology require careful preservation of cellular architecture, which is less important for biopsies used for the diagnosis of other pathologies such as malignancy . Exploration of alternative methodologies to obtain adequate muscle biopsy samples is therefore of benefit to patients and patient care.
Local protocol utilises a combination of clinical evaluation and MRI routinely to identify suitable targets for muscle biopsy by open surgical biopsy procedure. MRI is used to identify muscles that do not demonstrate significant fat content with preference to those demonstrating features of active disease with intrinsic muscle and peri-fascial oedema (Figure 1).