Muscular dystrophies
•Download as PPT, PDF•
13 likes•421 views
Duchene muscular dystrophy, Becker, Facioscapulohumeral dystrophy, scapuloperoneal, restricted ocular and oculopharyngeal myopathies, myotonic dystrophy, congenital myotonic dystrophy, infectious, idiopathic polymyositis and dermatomyositis
Report
Share
Report
Share
Recommended
Claw hand
Claw hand, or intrinsic minus hand, is caused by paralysis of the intrinsic hand muscles due to ulnar nerve injury. This results in hyperextension of the MP joints and flexion of the PIP and DIP joints, impairing hand function. Management involves restoring flexion at the MP joints and extension at the PIP joints through static procedures like capsulotomy or dynamic tendon transfers. Dynamic transfers use expendable donor tendons like the ECRL/ECRB to restore finger flexion and grip strength. Legendary orthopedic surgeon Dr. Paul Brand pioneered many tendon transfer techniques for treating leprosy-related hand deformities and rehabilitating patients.
Orthopedic Aspects Of Metabolic Bone Disease By Xiu
This document summarizes various metabolic bone diseases and their orthopedic manifestations and radiographic findings. It covers osteoporosis, rickets and osteomalacia, hyperparathyroidism, hypoparathyroidism, hyperthyroidism, and renal osteodystrophy. For each condition, it describes clinical presentation, pathogenesis, characteristic radiographic findings including areas of bone involvement and patterns of bone changes, and differential diagnoses.
Meralgia Paresthetica
Meralgia Paresthetica (MP) is a condition caused by impingement of the lateral femoral cutaneous nerve, causing numbness and pain along the front of the thigh. It is often caused by entrapment of the nerve under the inguinal ligament. Diagnosis involves history, physical exam including the pelvic compression test, and may include imaging or nerve blocks. Treatment options include removing any underlying causes, medications, physical therapy, injections, or surgery.
Limb length discrepency
This document discusses limb length discrepancy (LLD), including its definition, causes, effects, evaluation, and management. LLD is when one lower limb is noticeably longer than the other. It is classified as structural or functional. LLD of 2.5 cm or more can cause back/hip/knee pain and gait abnormalities. Evaluation involves history, exam including block testing, and imaging like scansograms. LLD can be managed non-surgically with shoe lifts for small discrepancies or surgically with epiphysiodesis or bone lengthening depending on the severity.
Assessment Of Glenoid Bone Loss In Recurrent Shoulder Dislocation
Bigliani coined the term glenoid rim lesions
glenoid rim erosion and
bony Bankart lesion,
Itoi et al. cadaveric study inferred that glenoid defect more than 21% produces anterior instability.
Lo and Burkhart named significant bone loss as
“inverted-pear glenoid” and
“engaging Hill-Sachs lesion”
shoulders associated with these significant bone loss are not suitable candidates for arthroscopic soft tissue stabilization
X ray
2D CT scan
3D CT scan
MRI
Arthroscopy
Principles of Tendon transfer and basics of tendon transfer for radial nerve ...
1) Tendon transfers relocate functioning muscle-tendon units to restore lost movement from nerve injuries. They follow principles like having supple joints, a straight line of pull, and using an expendable donor muscle.
2) Timing of tendon transfers is classified as early, conventional, or late. Conventional transfers are typically done 3 months after expected nerve recovery fails.
3) Post-operatively, tendon transfers are immobilized for 4 weeks to heal, followed by gentle rehabilitation including stretching, strengthening, and weaning from splints.
Wrist drop
The radial nerve innervates the extensor muscles of the forearm and hand. Damage to the radial nerve causes wrist drop where the patient is unable to extend the wrist and fingers, impairing grasping. Symptoms include pain, numbness, weakness of hand grip and drooping of the wrist and fingers. Diagnosis involves assessing range of motion, imaging tests and electrodiagnostic tests. Treatment depends on the underlying cause but may include medications, injections, bracing and physical therapy.
Mallet finger
This document discusses mallet finger injuries, which involve disruption of the extensor tendon mechanism at the distal interphalangeal joint. It covers the anatomy of the finger extensor mechanism, classification of mallet finger injuries, clinical evaluation, treatment options including nonsurgical management with splinting and surgical repair or fixation, and management approaches for different types of acute mallet finger injuries.
Recommended
Claw hand
Claw hand, or intrinsic minus hand, is caused by paralysis of the intrinsic hand muscles due to ulnar nerve injury. This results in hyperextension of the MP joints and flexion of the PIP and DIP joints, impairing hand function. Management involves restoring flexion at the MP joints and extension at the PIP joints through static procedures like capsulotomy or dynamic tendon transfers. Dynamic transfers use expendable donor tendons like the ECRL/ECRB to restore finger flexion and grip strength. Legendary orthopedic surgeon Dr. Paul Brand pioneered many tendon transfer techniques for treating leprosy-related hand deformities and rehabilitating patients.
Orthopedic Aspects Of Metabolic Bone Disease By Xiu
This document summarizes various metabolic bone diseases and their orthopedic manifestations and radiographic findings. It covers osteoporosis, rickets and osteomalacia, hyperparathyroidism, hypoparathyroidism, hyperthyroidism, and renal osteodystrophy. For each condition, it describes clinical presentation, pathogenesis, characteristic radiographic findings including areas of bone involvement and patterns of bone changes, and differential diagnoses.
Meralgia Paresthetica
Meralgia Paresthetica (MP) is a condition caused by impingement of the lateral femoral cutaneous nerve, causing numbness and pain along the front of the thigh. It is often caused by entrapment of the nerve under the inguinal ligament. Diagnosis involves history, physical exam including the pelvic compression test, and may include imaging or nerve blocks. Treatment options include removing any underlying causes, medications, physical therapy, injections, or surgery.
Limb length discrepency
This document discusses limb length discrepancy (LLD), including its definition, causes, effects, evaluation, and management. LLD is when one lower limb is noticeably longer than the other. It is classified as structural or functional. LLD of 2.5 cm or more can cause back/hip/knee pain and gait abnormalities. Evaluation involves history, exam including block testing, and imaging like scansograms. LLD can be managed non-surgically with shoe lifts for small discrepancies or surgically with epiphysiodesis or bone lengthening depending on the severity.
Assessment Of Glenoid Bone Loss In Recurrent Shoulder Dislocation
Bigliani coined the term glenoid rim lesions
glenoid rim erosion and
bony Bankart lesion,
Itoi et al. cadaveric study inferred that glenoid defect more than 21% produces anterior instability.
Lo and Burkhart named significant bone loss as
“inverted-pear glenoid” and
“engaging Hill-Sachs lesion”
shoulders associated with these significant bone loss are not suitable candidates for arthroscopic soft tissue stabilization
X ray
2D CT scan
3D CT scan
MRI
Arthroscopy
Principles of Tendon transfer and basics of tendon transfer for radial nerve ...
1) Tendon transfers relocate functioning muscle-tendon units to restore lost movement from nerve injuries. They follow principles like having supple joints, a straight line of pull, and using an expendable donor muscle.
2) Timing of tendon transfers is classified as early, conventional, or late. Conventional transfers are typically done 3 months after expected nerve recovery fails.
3) Post-operatively, tendon transfers are immobilized for 4 weeks to heal, followed by gentle rehabilitation including stretching, strengthening, and weaning from splints.
Wrist drop
The radial nerve innervates the extensor muscles of the forearm and hand. Damage to the radial nerve causes wrist drop where the patient is unable to extend the wrist and fingers, impairing grasping. Symptoms include pain, numbness, weakness of hand grip and drooping of the wrist and fingers. Diagnosis involves assessing range of motion, imaging tests and electrodiagnostic tests. Treatment depends on the underlying cause but may include medications, injections, bracing and physical therapy.
Mallet finger
This document discusses mallet finger injuries, which involve disruption of the extensor tendon mechanism at the distal interphalangeal joint. It covers the anatomy of the finger extensor mechanism, classification of mallet finger injuries, clinical evaluation, treatment options including nonsurgical management with splinting and surgical repair or fixation, and management approaches for different types of acute mallet finger injuries.
Dupuytrens Contracture
Apply gentle pressure proximally
Surgeon: Check distal pulses and capillary refill
If no improvement:
Consider temporary arteriotomy or venous shunt
Delay closure and observe
Flap or graft may be needed
Sushil seminar ctev
- Holds foot in corrected position
Surgeon:
- Manipulates foot into corrected position
- Applies cast
Key points:
- Gentle manipulation
- Plantar flexion, abduction, derotation
- Cast applied in corrected position
- Check for pressure areas
- Weekly follow up for cast changes
Percutaneous Achilles tenotomy
- Done under local anesthesia
- Foot held in corrected position
- Small stab incision over tendon
- Tenotomy performed with small clamp or tenotomy knife
- Cast applied in corrected position
Benefits:
- Allows full correction of hindfoot equinus
- Minimally invasive
- Low complication rate
Risks
Assessment of higher motor functions
This document discusses assessing higher motor functions, including the sensorium, perception, and speech difficulties. It describes the sensorium and its parts like consciousness, attention, orientation, memory, and insight. Regarding perception, it discusses distortions like illusions, hallucinations, and delusions. It defines agnosia as the inability to understand sensory stimuli and lists types of agnosia. Apraxia is defined as the inability to perform voluntary acts despite intact motor function. Types of apraxia are described. Speech disorders include aphasia and other difficulties. The document outlines examining level of consciousness and provides references.
Morton Neuroma
Morton's neuroma is a compressive neuropathy of the interdigital nerve in the forefoot caused by compression at the plantar aspect of the transverse intermetatarsal ligament. It commonly occurs between the second and third metatarsal bones and affects middle-aged women. Non-surgical treatments include wider shoes, padding, anti-inflammatories, and injections, but surgery may be required if conservative measures fail.
Tendon transfer in neuro-muscular foot
Main etiology of Foot deformity in neuro-muscular disorder is muscular weakness & tone imbalance. Most of time this deformity is progressive so it is very important to have a permanent solution. Tendon transfer plays a very important role in balancing the muscle tone & power around the foot.
Peripheral nerve injury
This document provides information on peripheral nerve injuries, including the structure of nerves, classifications of nerve injuries, common sites of injury for specific nerves like the ulnar and radial nerves, clinical features of injuries, and treatment approaches. It details Seddon's and Sunderland's classifications of nerve injuries, which range from neurapraxia to neurotmesis depending on the severity of axonal and neural sheath damage. Specific injuries like ulnar nerve entrapment at the elbow or Guyon's canal are discussed. Both non-surgical and surgical treatment options are presented.
Sprengle shoulder (congenital elevation of scapula)
Sprengel deformity is a congenital condition where the scapula is elevated higher than normal due to failed descent during development. It can range from mild where motion is slightly limited, to severe where the scapula touches the head. Surgery is aimed at lowering the scapula, and involves releasing muscles and reattaching them in a lower position. Complications include brachial plexus injury, so preventative clavicle resection may be used. Sprengel deformity is classified based on the degree of elevation and angle of the scapula.
Charcot joint / Neuropathic Joint
Charcot joint or neuropathic joint are destructed joint occurs in Diabetes, syphilis, syringomyelia , leprosy, AMLS, Peripheral neuropathy and any condition leads to impair sensation of peripheral part of body
Orthosis PPT
This document provides an overview of orthosis, including definitions of splints and braces, classifications of orthosis, principles of splint design, materials used, prefabricated splints, and biomechanical principles. It also describes various upper and lower limb orthosis, such as figure of eight axilla wraps, gunslinger splints, airplane splints, hemi arm slings, elbow flexion harnesses, cockup splints, and more. The objectives, indications, and designs of different orthosis are discussed in detail.
Haemophilic Arthropathy (PMR)
This document summarizes information about haemophilia, including:
- It is a genetic bleeding disorder caused by deficiencies in coagulation factors VIII or IX.
- It leads to recurrent bleeding episodes into joints and muscles.
- Repeated bleeding can cause chronic joint damage and deformities over time.
- Treatment involves replacing the deficient clotting factor, managing pain, and physical therapy to prevent joint damage. Early intervention and splinting can help correct deformities and maintain range of motion.
Muscular dystrophy
Muscular dystrophy is a group of diseases that cause progressive weakness and loss of muscle mass. In muscular dystrophy, abnormal genes (mutations) interfere with the production of proteins needed to form healthy muscle.
Intraartiular knee injection
This is a short presentation on intraarticular knee injection. This presentation gives brief idea about hyaluronic acid injection used for management of osteoarthritic pain.
Hyaluronic acid is substance similar to the synovial fluid which is present in our knees. It is a viscosupplementation injection that lubricates and helps to cushion the joint. The mechanism of action of the injection is it stimulates the natural lining of the joint to produce natural joint fluid, reduces joint pain by coating the damaged joint lining and by its anti inflammatory action.
Prof sobh renal osteodystrophy
The document discusses renal osteodystrophy, which refers to bone diseases that occur in patients with impaired kidney function. It outlines several types of renal osteodystrophy, including osteitis fibrosa, adynamic bone disease, and osteomalacia. It describes the pathogenesis of secondary hyperparathyroidism in kidney disease and the effects of parathyroid hormone and vitamin D on bone and mineral metabolism. Treatment goals are to control parathyroid hormone levels, calcium, phosphorus, and vitamin D to prevent bone complications in renal patients.
Metabolic disorders of bone
This document discusses rickets, including its causes, signs and symptoms, diagnosis, and treatment. Rickets is caused by a lack of vitamin D, calcium, or phosphate, which can result from inadequate sunlight exposure, poor nutrition, liver or kidney diseases, and some medications. Clinical features include bone deformities, muscle weakness, and growth delays. Diagnosis involves physical exam, lab tests showing low calcium and vitamin D levels and high alkaline phosphatase, and x-rays revealing bone changes. Treatment focuses on high dose vitamin D supplementation in the short term, followed by lower lifelong doses, along with ensuring adequate calcium and phosphate intake.
Cervical myelopathy cme
Cervical disc disorders include cervical spondylosis, radiculopathy, and myelopathy. Cervical spondylosis is a general term referring to degenerative changes in the cervical spine. It commonly causes neck pain but can also cause radiculopathy or myelopathy. Cervical radiculopathy involves compression of a cervical nerve root, causing pain and weakness along the nerve distribution. Cervical myelopathy refers to compression of the spinal cord, which can cause gait abnormalities, leg weakness, and hand/arm symptoms. Management involves conservative treatments like physical therapy initially, with surgery considered for worsening or persistent symptoms.
Shoulder Instability
This document discusses shoulder instability, including definitions, anatomy, evaluation, and treatment. It defines instability as the inability to maintain the humeral head in the glenoid fossa, ranging from dislocation to laxity. Static stabilizers include the labrum and ligaments, while dynamic stabilizers are the rotator cuff and scapulothoracic muscles. Evaluation involves history, exam, and imaging to classify instability by direction, degree, and etiology. Treatment depends on classification but may include immobilization, rehabilitation, or surgical repair of labral tears or bone defects.
Deformities of hand in rheumatoid arthritis
Rheumatoid arthritis can cause deformities of the fingers including intrinsic plus, swan neck, and buttonhole deformities. Swan neck deformity involves flexion of the distal interphalangeal joint and hyperextension of the proximal interphalangeal joint. Buttonhole deformity is the reverse, with flexion of the proximal interphalangeal joint and hyperextension of the distal interphalangeal joint. Both deformities result from muscle imbalance and can be caused by synovitis, tendon damage, or capsular changes within the finger joints. Surgical correction may involve synovectomy, tendon releases or reconstructions, and joint mobilization or fusion depending on the severity and chronicity of the
Reverse Total Shoulder Replacement, Final
The document discusses reverse total shoulder arthroplasty (rTSA), including:
- The procedure reverses the ball and socket of the shoulder joint.
- It was approved for use in the US in 2004.
- The new design moves the center of rotation medially and inferiorly, increasing deltoid tension and function as the primary shoulder elevator.
- Indications include severe rotator cuff deficiency or previous TSA failure. Contraindications include infection or inadequate bone stock. Potential complications range from minor issues like stiffness or hematoma to more serious problems like prosthesis loosening or nerve damage.
Dupuytrens contracture
Dupuytren's contracture is a condition causing the fingers to bend towards the palm due to fibrosis of the palmar fascia. It typically affects men over 50 years old and has an autosomal dominant inheritance pattern. Clinically, patients present with nodules and cords in the palm leading to finger contractures. Treatment options include observation for slow cases, radiotherapy in early stages, and surgery involving fasciotomy or fasciectomy. Complete fasciectomy has high recurrence rates while partial fasciectomy balances effectiveness and risk of recurrence. Post-operative splinting and exercises are needed to regain finger extension.
Nerve injury
This document discusses nerve injury classification and techniques for nerve regeneration and repair. It describes two main classification systems - Seddon from 1943 and Sunderland from 1951. Seddon classified injuries as neuroprexia, axonotmesis, or neurotmesis. Sunderland's more detailed system classified injuries from 1st to 5th degree based on the anatomical structures disrupted. The document also discusses nerve degeneration, regeneration, diagnostic tests like nerve conduction studies and EMG, and techniques for nerve repair including neurolysis, neurorrhaphy, and nerve grafting.
Spondylolisthesis
1) Spondylolisthesis is the slipping of one vertebra over another, usually caused by a defect in the pars interarticularis. It is classified based on its etiology and degree of slip.
2) Symptoms depend on the severity and include back pain, hamstring tightness, and sciatica. Examination may reveal a step in the back, tenderness over the pars defect, and limited back movement.
3) Imaging shows the degree of slip and any pars defect. Treatment focuses on pain relief through non-operative measures like physiotherapy initially, with surgery considered for more severe cases.
Spondylolisthesis
1) Spondylolisthesis is the slipping of one vertebra over another, usually caused by a defect in the pars interarticularis. It is classified based on its etiology and degree of slip.
2) Symptoms depend on the severity and include back pain, hamstring tightness, and sciatica. Examination may reveal a step in the back, tenderness over the pars defect, and limited back movement.
3) Imaging shows the degree of slip. Treatment focuses on pain relief through non-operative measures like physiotherapy. Surgery is considered if conservative treatment fails or neurological symptoms are present.
More Related Content
What's hot
Dupuytrens Contracture
Apply gentle pressure proximally
Surgeon: Check distal pulses and capillary refill
If no improvement:
Consider temporary arteriotomy or venous shunt
Delay closure and observe
Flap or graft may be needed
Sushil seminar ctev
- Holds foot in corrected position
Surgeon:
- Manipulates foot into corrected position
- Applies cast
Key points:
- Gentle manipulation
- Plantar flexion, abduction, derotation
- Cast applied in corrected position
- Check for pressure areas
- Weekly follow up for cast changes
Percutaneous Achilles tenotomy
- Done under local anesthesia
- Foot held in corrected position
- Small stab incision over tendon
- Tenotomy performed with small clamp or tenotomy knife
- Cast applied in corrected position
Benefits:
- Allows full correction of hindfoot equinus
- Minimally invasive
- Low complication rate
Risks
Assessment of higher motor functions
This document discusses assessing higher motor functions, including the sensorium, perception, and speech difficulties. It describes the sensorium and its parts like consciousness, attention, orientation, memory, and insight. Regarding perception, it discusses distortions like illusions, hallucinations, and delusions. It defines agnosia as the inability to understand sensory stimuli and lists types of agnosia. Apraxia is defined as the inability to perform voluntary acts despite intact motor function. Types of apraxia are described. Speech disorders include aphasia and other difficulties. The document outlines examining level of consciousness and provides references.
Morton Neuroma
Morton's neuroma is a compressive neuropathy of the interdigital nerve in the forefoot caused by compression at the plantar aspect of the transverse intermetatarsal ligament. It commonly occurs between the second and third metatarsal bones and affects middle-aged women. Non-surgical treatments include wider shoes, padding, anti-inflammatories, and injections, but surgery may be required if conservative measures fail.
Tendon transfer in neuro-muscular foot
Main etiology of Foot deformity in neuro-muscular disorder is muscular weakness & tone imbalance. Most of time this deformity is progressive so it is very important to have a permanent solution. Tendon transfer plays a very important role in balancing the muscle tone & power around the foot.
Peripheral nerve injury
This document provides information on peripheral nerve injuries, including the structure of nerves, classifications of nerve injuries, common sites of injury for specific nerves like the ulnar and radial nerves, clinical features of injuries, and treatment approaches. It details Seddon's and Sunderland's classifications of nerve injuries, which range from neurapraxia to neurotmesis depending on the severity of axonal and neural sheath damage. Specific injuries like ulnar nerve entrapment at the elbow or Guyon's canal are discussed. Both non-surgical and surgical treatment options are presented.
Sprengle shoulder (congenital elevation of scapula)
Sprengel deformity is a congenital condition where the scapula is elevated higher than normal due to failed descent during development. It can range from mild where motion is slightly limited, to severe where the scapula touches the head. Surgery is aimed at lowering the scapula, and involves releasing muscles and reattaching them in a lower position. Complications include brachial plexus injury, so preventative clavicle resection may be used. Sprengel deformity is classified based on the degree of elevation and angle of the scapula.
Charcot joint / Neuropathic Joint
Charcot joint or neuropathic joint are destructed joint occurs in Diabetes, syphilis, syringomyelia , leprosy, AMLS, Peripheral neuropathy and any condition leads to impair sensation of peripheral part of body
Orthosis PPT
This document provides an overview of orthosis, including definitions of splints and braces, classifications of orthosis, principles of splint design, materials used, prefabricated splints, and biomechanical principles. It also describes various upper and lower limb orthosis, such as figure of eight axilla wraps, gunslinger splints, airplane splints, hemi arm slings, elbow flexion harnesses, cockup splints, and more. The objectives, indications, and designs of different orthosis are discussed in detail.
Haemophilic Arthropathy (PMR)
This document summarizes information about haemophilia, including:
- It is a genetic bleeding disorder caused by deficiencies in coagulation factors VIII or IX.
- It leads to recurrent bleeding episodes into joints and muscles.
- Repeated bleeding can cause chronic joint damage and deformities over time.
- Treatment involves replacing the deficient clotting factor, managing pain, and physical therapy to prevent joint damage. Early intervention and splinting can help correct deformities and maintain range of motion.
Muscular dystrophy
Muscular dystrophy is a group of diseases that cause progressive weakness and loss of muscle mass. In muscular dystrophy, abnormal genes (mutations) interfere with the production of proteins needed to form healthy muscle.
Intraartiular knee injection
This is a short presentation on intraarticular knee injection. This presentation gives brief idea about hyaluronic acid injection used for management of osteoarthritic pain.
Hyaluronic acid is substance similar to the synovial fluid which is present in our knees. It is a viscosupplementation injection that lubricates and helps to cushion the joint. The mechanism of action of the injection is it stimulates the natural lining of the joint to produce natural joint fluid, reduces joint pain by coating the damaged joint lining and by its anti inflammatory action.
Prof sobh renal osteodystrophy
The document discusses renal osteodystrophy, which refers to bone diseases that occur in patients with impaired kidney function. It outlines several types of renal osteodystrophy, including osteitis fibrosa, adynamic bone disease, and osteomalacia. It describes the pathogenesis of secondary hyperparathyroidism in kidney disease and the effects of parathyroid hormone and vitamin D on bone and mineral metabolism. Treatment goals are to control parathyroid hormone levels, calcium, phosphorus, and vitamin D to prevent bone complications in renal patients.
Metabolic disorders of bone
This document discusses rickets, including its causes, signs and symptoms, diagnosis, and treatment. Rickets is caused by a lack of vitamin D, calcium, or phosphate, which can result from inadequate sunlight exposure, poor nutrition, liver or kidney diseases, and some medications. Clinical features include bone deformities, muscle weakness, and growth delays. Diagnosis involves physical exam, lab tests showing low calcium and vitamin D levels and high alkaline phosphatase, and x-rays revealing bone changes. Treatment focuses on high dose vitamin D supplementation in the short term, followed by lower lifelong doses, along with ensuring adequate calcium and phosphate intake.
Cervical myelopathy cme
Cervical disc disorders include cervical spondylosis, radiculopathy, and myelopathy. Cervical spondylosis is a general term referring to degenerative changes in the cervical spine. It commonly causes neck pain but can also cause radiculopathy or myelopathy. Cervical radiculopathy involves compression of a cervical nerve root, causing pain and weakness along the nerve distribution. Cervical myelopathy refers to compression of the spinal cord, which can cause gait abnormalities, leg weakness, and hand/arm symptoms. Management involves conservative treatments like physical therapy initially, with surgery considered for worsening or persistent symptoms.
Shoulder Instability
This document discusses shoulder instability, including definitions, anatomy, evaluation, and treatment. It defines instability as the inability to maintain the humeral head in the glenoid fossa, ranging from dislocation to laxity. Static stabilizers include the labrum and ligaments, while dynamic stabilizers are the rotator cuff and scapulothoracic muscles. Evaluation involves history, exam, and imaging to classify instability by direction, degree, and etiology. Treatment depends on classification but may include immobilization, rehabilitation, or surgical repair of labral tears or bone defects.
Deformities of hand in rheumatoid arthritis
Rheumatoid arthritis can cause deformities of the fingers including intrinsic plus, swan neck, and buttonhole deformities. Swan neck deformity involves flexion of the distal interphalangeal joint and hyperextension of the proximal interphalangeal joint. Buttonhole deformity is the reverse, with flexion of the proximal interphalangeal joint and hyperextension of the distal interphalangeal joint. Both deformities result from muscle imbalance and can be caused by synovitis, tendon damage, or capsular changes within the finger joints. Surgical correction may involve synovectomy, tendon releases or reconstructions, and joint mobilization or fusion depending on the severity and chronicity of the
Reverse Total Shoulder Replacement, Final
The document discusses reverse total shoulder arthroplasty (rTSA), including:
- The procedure reverses the ball and socket of the shoulder joint.
- It was approved for use in the US in 2004.
- The new design moves the center of rotation medially and inferiorly, increasing deltoid tension and function as the primary shoulder elevator.
- Indications include severe rotator cuff deficiency or previous TSA failure. Contraindications include infection or inadequate bone stock. Potential complications range from minor issues like stiffness or hematoma to more serious problems like prosthesis loosening or nerve damage.
Dupuytrens contracture
Dupuytren's contracture is a condition causing the fingers to bend towards the palm due to fibrosis of the palmar fascia. It typically affects men over 50 years old and has an autosomal dominant inheritance pattern. Clinically, patients present with nodules and cords in the palm leading to finger contractures. Treatment options include observation for slow cases, radiotherapy in early stages, and surgery involving fasciotomy or fasciectomy. Complete fasciectomy has high recurrence rates while partial fasciectomy balances effectiveness and risk of recurrence. Post-operative splinting and exercises are needed to regain finger extension.
Nerve injury
This document discusses nerve injury classification and techniques for nerve regeneration and repair. It describes two main classification systems - Seddon from 1943 and Sunderland from 1951. Seddon classified injuries as neuroprexia, axonotmesis, or neurotmesis. Sunderland's more detailed system classified injuries from 1st to 5th degree based on the anatomical structures disrupted. The document also discusses nerve degeneration, regeneration, diagnostic tests like nerve conduction studies and EMG, and techniques for nerve repair including neurolysis, neurorrhaphy, and nerve grafting.
What's hot (20)
Sprengle shoulder (congenital elevation of scapula)
Sprengle shoulder (congenital elevation of scapula)
Similar to Muscular dystrophies
Spondylolisthesis
1) Spondylolisthesis is the slipping of one vertebra over another, usually caused by a defect in the pars interarticularis. It is classified based on its etiology and degree of slip.
2) Symptoms depend on the severity and include back pain, hamstring tightness, and sciatica. Examination may reveal a step in the back, tenderness over the pars defect, and limited back movement.
3) Imaging shows the degree of slip and any pars defect. Treatment focuses on pain relief through non-operative measures like physiotherapy initially, with surgery considered for more severe cases.
Spondylolisthesis
1) Spondylolisthesis is the slipping of one vertebra over another, usually caused by a defect in the pars interarticularis. It is classified based on its etiology and degree of slip.
2) Symptoms depend on the severity and include back pain, hamstring tightness, and sciatica. Examination may reveal a step in the back, tenderness over the pars defect, and limited back movement.
3) Imaging shows the degree of slip. Treatment focuses on pain relief through non-operative measures like physiotherapy. Surgery is considered if conservative treatment fails or neurological symptoms are present.
musculardystrophiesppt-170130163640.pdf
This document discusses Duchenne muscular dystrophy (DMD), a genetic disorder characterized by progressive muscle degeneration and weakness. It is caused by mutations in the dystrophin gene leading to absence of the dystrophin protein. The document outlines the clinical presentation and stages of DMD from early childhood to late stages requiring wheelchair use. It also discusses diagnostic testing, management including cardiac and nutritional support, genetic counseling and potential future treatments like exon skipping drugs.
MUSCULAR DYSTROPHIES
This document discusses Duchenne muscular dystrophy (DMD), a genetic disorder characterized by progressive muscle degeneration and weakness. It is caused by mutations in the dystrophin gene leading to absence of the dystrophin protein. The document outlines the clinical presentation and stages of DMD from early childhood to late stages requiring wheelchair use. It also discusses diagnostic testing, management including cardiac and nutritional support, genetic counseling and potential new treatments like exon skipping drugs.
Muscular dystrophies
This document discusses Duchenne muscular dystrophy (DMD), a genetic disorder characterized by progressive muscle degeneration and weakness. It is caused by mutations in the dystrophin gene leading to absence of the dystrophin protein. The document outlines the clinical presentation and stages of DMD from early childhood to late stages requiring wheelchair use. It also discusses diagnostic testing, management including cardiac and nutritional support, genetic counseling and potential future treatments like exon skipping drugs.
Spondylolisthesis
This document provides information on spondylolisthesis, including its definition, classification systems, etiology, natural history, clinical evaluation, radiographic findings, and management. Spondylolisthesis is defined as the slipping of one vertebra over another, most commonly of L5 over S1. It is classified based on etiology, including dysplastic, isthmic, degenerative, traumatic, and pathological types. Causes include developmental defects, stress fractures of the pars interarticularis, degeneration of the disc and facets, acute fractures, and bone diseases. Progression risks include young age, female sex, slip angle over 10 degrees, and sacral morphology. Evaluation involves history, exam looking for signs
floppyinfant3-150627123231-lva1-app6891.pdf
Floppy infant syndrome is characterized by reduced muscle tone and weakness in infants. It is caused by central nervous system disorders or neuromuscular disorders. CNS disorders are more common causes. Causes can be divided into those affecting the central nervous system ("floppy strong") or the peripheral nervous system ("floppy weak"). Evaluation of a floppy infant includes examining for signs of systemic illness, respiratory failure, family history of neuromuscular disorders, and tests of blood glucose, electrolytes, imaging and metabolic function to determine the underlying cause and guide management and prognosis. Treatment depends on the specific cause but may include respiratory support, examining family members, and specialist consultation.
Floppy infant
Floppy infant syndrome is characterized by reduced muscle tone and weakness in infants. It is caused by a variety of central nervous system and neuromuscular disorders. Causes can be divided into central/CNS issues ("floppy strong") or peripheral issues involving motor neurons, neuromuscular junction, or muscle disease ("floppy weak"). Evaluation involves examining family history, assessing signs and symptoms, and testing for conditions like metabolic myopathies, spinal muscular atrophy, or myasthenia gravis. Management depends on the underlying cause but may include respiratory support, treating infections, and specialist referrals. Prognosis varies greatly depending on the specific condition causing floppiness.
perthes.ppt
This document discusses Perthes disease, which is a self-limiting condition causing necrosis of the femoral head. It defines the disease and provides synonyms. It discusses the vascular supply and blood flow to the femoral head in children and adults. It outlines Trueta's hypothesis about the changes in blood supply with age and how this relates to the occurrence of Perthes disease. The document also covers etiological factors, epidemiology, clinical features, natural history, investigations, pathogenesis and differential diagnosis of Perthes disease.
71252786117d6aa1344a0f53179ba910 (1).pdf
This document discusses Duchenne muscular dystrophy (DMD), the most common form of muscular dystrophy. DMD is an X-linked recessive genetic disorder caused by mutations in the dystrophin gene. This results in progressive muscle degeneration and weakness. The document outlines the characteristic features and stages of DMD as well as methods of genetic testing, management, and potential exon skipping treatments that are being investigated.
Dwarfism, bonydysplasia
This document provides an overview of dwarfism (bone dysplasias), including classification, causes, signs and symptoms, radiographic findings, and treatment for various types. It discusses proportionate vs disproportionate dwarfism and classifications based on location and source. Specific types covered include achondroplasia, spondyloepiphyseal dysplasia, chondrodysplasia punctata, Kniest syndrome, metaphyseal chondrodysplasia, multiple epiphyseal dysplasia, and mucopolysaccharidoses. Treatment focuses on managing skeletal deformities and complications.
Proximal limb girdle syndromes approach
The document summarizes proximal limb girdle syndromes, including:
1. The most common pattern of muscle weakness involves predominantly the proximal muscles of the legs and arms, with distal muscles also involved to a lesser extent.
2. Common causes include spinal muscular atrophies, muscular dystrophies like Duchenne, inflammatory myopathies like polymyositis and dermatomyositis, and endocrine myopathies.
3. Diagnosis is based on pattern of inheritance like autosomal dominant for FSHD and LGMD type-1 or autosomal recessive for LGMD and metabolic myopathies.
Muscular dystrophy. an overview
This document discusses muscular dystrophy, including its definition, types, causes, symptoms, diagnosis, and management. The main points are:
1. Muscular dystrophy is a genetic disorder that causes progressive weakness and degeneration in the skeletal muscles. It is caused by deficiencies in dystrophin and other proteins important for muscle fiber integrity.
2. The main types include Duchenne MD, Becker MD, limb-girdle MD, and myotonic dystrophy. They vary in inheritance, onset, muscles affected, and progression.
3. Symptoms depend on the type but generally include muscle weakness, loss of mobility, and contractures. Management focuses on physiotherapy, medications, assistive
OSTEONECROSIS 2003.ppt
This document discusses Legg-Calve-Perthes disease, which is avascular necrosis of the femoral head that occurs in children. It begins by describing the etiology as an ischemic episode affecting the capital femoral epiphysis, though the exact cause is unknown. The stages of the disease are then outlined based on radiographic appearance, from initial avascular necrosis to revascularization and bone remodeling. Complications including deformities of the femoral head and neck are also summarized. The document provides detailed information on the radiographic signs and classifications systems used to evaluate the progression and prognosis of Legg-Calve-Perthes disease.
Legg's calve perthes disease
A 7-year-old boy presented with right groin pain and limping. He was diagnosed with Legg-Calvé-Perthes disease, which is avascular necrosis of the femoral head of unknown cause. It most commonly affects boys ages 4-12. The disease process involves bone death, fragmentation, and reossification of the femoral head, which can lead to deformities like flattening if not properly contained and allowed to heal. Treatment aims to relieve weight bearing and maintain range of motion to preserve the round femoral head shape during healing.
Muscular dystrophy
Muscular dystrophy is a genetic disorder characterized by progressive skeletal muscle weakness. The most common type is Duchenne muscular dystrophy, which is caused by a lack of the muscle protein dystrophin. Clinical features include muscle wasting, impaired balance and mobility, scoliosis, respiratory difficulties, and in late stages, weakness of upper limb muscles. Physiotherapy management focuses on maintaining strength and range of motion, preventing deformities, improving respiratory function, and assisting with activities of daily living through the different stages of the disease.
9 CEREBRAL PALSY.pptx as a cause of disabilities
Cerebral palsy is a chronic disorder of movement, posture and coordination arising from a non-progressive brain lesion occurring before the age of 2. It is usually caused by prenatal infections, genetic factors, complications during birth, or postnatal infections/trauma. The main types are spastic, dyskinetic, and ataxic. Spastic cerebral palsy is the most common and can affect one or more limbs. It is characterized by spasticity, exaggerated reflexes, and contractures. Treatment focuses on physiotherapy, occupational therapy, medications, and surgery to manage symptoms and improve function.
Floppy infant
The document discusses hypotonia in infants and provides details on:
- The differential diagnosis of hypotonia includes both benign and serious conditions.
- Hypotonia can be caused by central nervous system issues or peripheral nervous system issues. Central causes account for 60-80% of cases.
- The evaluation of an infant with hypotonia includes a detailed history, physical exam focusing on tone and strength, and initial screening tests. Further testing may include imaging, genetic testing, and metabolic testing depending on exam findings.
Paraparesis biplave nams
1) Paraplegia is defined as impairment of motor function in the lower extremities, which can be caused by lesions in the cerebral cortex, spinal cord, nerves supplying the lower limbs, or muscles directly.
2) Complete paralysis of both lower limbs is known as paraplegia, while partial paralysis is called paraparesis. Lesions that transect motor tracts cause spastic paraplegia or quadriplegia with heightened reflexes.
3) Determining the level and type of spinal cord lesion is important for diagnosis and involves assessing sensory loss, motor weakness, reflex changes, and associated symptoms.
paraparesisbiplavenams-190401002135.pdf
1) Paraplegia is defined as impairment of motor function in the lower extremities, which can be caused by lesions in the cerebral cortex, spinal cord, nerves supplying the lower limbs, or muscles directly.
2) The document provides details on the causes, features, levels of lesions, and approaches to examining a patient with paraplegia. Common causes include trauma, tumors, tuberculosis, thrombosis, and transverse myelitis.
3) Based on the level and completeness of the spinal cord lesion, the features of paraplegia such as muscle tone, reflexes, and sensory involvement will differ. Determining the level of lesion is important for diagnosing the underlying cause.
Similar to Muscular dystrophies (20)
More from Dr. HIma
Exocrine neoplasms of pancreas
Exocrine neoplasms of pancreas, Introduction: Fifth leading cause of deaths from cancer,
Aggressive tumor biology, Advanced stage of disease @ diagnosis, Lack of effective systemic therapies....
Beta lactam antibiotics & other cell wall synthesis inhibitors
This document summarizes key information about penicillins and other beta-lactam antibiotics. It discusses their mechanisms of action inhibiting bacterial cell wall synthesis, pharmacokinetics varying by compound, clinical uses for treating various bacterial infections, and potential adverse effects like allergic reactions. Various subclasses are outlined including penicillins, cephalosporins, carbapenems, monobactams, and beta-lactamase inhibitor combinations. Specific antibiotics are highlighted along with their antimicrobial spectra and considerations for use.
Antihypertensive drugs
Main and important classes of anti-hypertensive drugs.
(antihypertensive drugs, anti hypertensive sites of action, diuretics, diuretics sites of action, sympathoplegic drugs, beta blockers, alpha blokers, vasodilators, calcium channel blockers)
Iodine ppt
Iodine is essential for the production of thyroid hormones and is concentrated in glandular tissues like the thyroid, breasts, and salivary glands. It is absorbed from foods like iodized salt, seaweed, and fish, with the daily requirement being 150 mcg. Iodine deficiency can promote disorders like goiter and increase the risk of cancers. Iodine has many therapeutic actions including being antibacterial, antifungal, anticancer, and helping conditions like asthma, diabetes, and fibrocystic breast disease. It can be used as a diagnostic tool and to treat thyroid disorders as well as decreasing vascularity before thyroid surgery.
More from Dr. HIma (6)
Beta lactam antibiotics & other cell wall synthesis inhibitors
Beta lactam antibiotics & other cell wall synthesis inhibitors
Recently uploaded
TEST BANK For Community Health Nursing A Canadian Perspective, 5th Edition by...
TEST BANK For Community Health Nursing A Canadian Perspective, 5th Edition by Stamler, Verified Chapters 1 - 33, Complete Newest Version Community Health Nursing A Canadian Perspective, 5th Edition by Stamler, Verified Chapters 1 - 33, Complete Newest Version Community Health Nursing A Canadian Perspective, 5th Edition by Stamler Community Health Nursing A Canadian Perspective, 5th Edition TEST BANK by Stamler Test Bank For Community Health Nursing A Canadian Perspective, 5th Edition Pdf Chapters Download Test Bank For Community Health Nursing A Canadian Perspective, 5th Edition Pdf Download Stuvia Test Bank For Community Health Nursing A Canadian Perspective, 5th Edition Study Guide Test Bank For Community Health Nursing A Canadian Perspective, 5th Edition Ebook Download Stuvia Test Bank For Community Health Nursing A Canadian Perspective, 5th Edition Questions and Answers Quizlet Test Bank For Community Health Nursing A Canadian Perspective, 5th Edition Studocu Test Bank For Community Health Nursing A Canadian Perspective, 5th Edition Quizlet Test Bank For Community Health Nursing A Canadian Perspective, 5th Edition Stuvia Community Health Nursing A Canadian Perspective, 5th Edition Pdf Chapters Download Community Health Nursing A Canadian Perspective, 5th Edition Pdf Download Course Hero Community Health Nursing A Canadian Perspective, 5th Edition Answers Quizlet Community Health Nursing A Canadian Perspective, 5th Edition Ebook Download Course hero Community Health Nursing A Canadian Perspective, 5th Edition Questions and Answers Community Health Nursing A Canadian Perspective, 5th Edition Studocu Community Health Nursing A Canadian Perspective, 5th Edition Quizlet Community Health Nursing A Canadian Perspective, 5th Edition Stuvia Community Health Nursing A Canadian Perspective, 5th Edition Test Bank Pdf Chapters Download Community Health Nursing A Canadian Perspective, 5th Edition Test Bank Pdf Download Stuvia Community Health Nursing A Canadian Perspective, 5th Edition Test Bank Study Guide Questions and Answers Community Health Nursing A Canadian Perspective, 5th Edition Test Bank Ebook Download Stuvia Community Health Nursing A Canadian Perspective, 5th Edition Test Bank Questions Quizlet Community Health Nursing A Canadian Perspective, 5th Edition Test Bank Studocu Community Health Nursing A Canadian Perspective, 5th Edition Test Bank Quizlet Community Health Nursing A Canadian Perspective, 5th Edition Test Bank Stuvia
Top 10 Best Ayurvedic Kidney Stone Syrups in India
we have mentioned the best 10 ayurvedic Kidney Stone Syrups. You can check all these products and choose the best one for yourself.
Hemodialysis: Chapter 4, Dialysate Circuit - Dr.Gawad
- Video recording of this lecture in English language: https://youtu.be/kqbnxVAZs-0
- Video recording of this lecture in Arabic language: https://youtu.be/SINlygW1Mpc
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Local Advanced Lung Cancer: Artificial Intelligence, Synergetics, Complex Sys...
Overall life span (LS) was 1671.7±1721.6 days and cumulative 5YS reached 62.4%, 10 years – 50.4%, 20 years – 44.6%. 94 LCP lived more than 5 years without cancer (LS=2958.6±1723.6 days), 22 – more than 10 years (LS=5571±1841.8 days). 67 LCP died because of LC (LS=471.9±344 days). AT significantly improved 5YS (68% vs. 53.7%) (P=0.028 by log-rank test). Cox modeling displayed that 5YS of LCP significantly depended on: N0-N12, T3-4, blood cell circuit, cell ratio factors (ratio between cancer cells-CC and blood cells subpopulations), LC cell dynamics, recalcification time, heparin tolerance, prothrombin index, protein, AT, procedure type (P=0.000-0.031). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and N0-12 (rank=1), thrombocytes/CC (rank=2), segmented neutrophils/CC (3), eosinophils/CC (4), erythrocytes/CC (5), healthy cells/CC (6), lymphocytes/CC (7), stick neutrophils/CC (8), leucocytes/CC (9), monocytes/CC (10). Correct prediction of 5YS was 100% by neural networks computing (error=0.000; area under ROC curve=1.0).
Efficacy of Avartana Sneha in Ayurveda
Avartana Sneha is a unique method of Preparation of Sneha Kalpana in Ayurveda, mainly it is indicated for the Vataja rogas.
Post-Menstrual Smell- When to Suspect Vaginitis.pptx
Do you have abnormal smell after periods? It may be vaginitis. Do not worry, herbal medicine Fuyan Pill can help you get a cure.
Best Ayurvedic medicine for Gas and Indigestion
Here is the updated list of Top Best Ayurvedic medicine for Gas and Indigestion and those are Gas-O-Go Syp for Dyspepsia | Lavizyme Syrup for Acidity | Yumzyme Hepatoprotective Capsules etc
TEST BANK For Basic and Clinical Pharmacology, 14th Edition by Bertram G. Kat...
TEST BANK For Basic and Clinical Pharmacology, 14th Edition by Bertram G. Kat...rightmanforbloodline
TEST BANK For Basic and Clinical Pharmacology, 14th Edition by Bertram G. Katzung, Verified Chapters 1 - 66, Complete Newest Version.
TEST BANK For Basic and Clinical Pharmacology, 14th Edition by Bertram G. Katzung, Verified Chapters 1 - 66, Complete Newest Version.
TEST BANK For Basic and Clinical Pharmacology, 14th Edition by Bertram G. Katzung, Verified Chapters 1 - 66, Complete Newest Version.
TEST BANK For Basic and Clinical Pharmacology, 14th Edition by Bertram G. Katzung, Verified Chapters 1 - 66, Complete Newest Version.REGULATION FOR COMBINATION PRODUCTS AND MEDICAL DEVICES.pptx
It includes regulation of combination products and medical devices. FDA and industry liaisons.
A Classical Text Review on Basavarajeeyam
Basavarajeeyam is a Sreshta Sangraha grantha (Compiled book ), written by Neelkanta kotturu Basavaraja Virachita. It contains 25 Prakaranas, First 24 Chapters related to Rogas& 25th to Rasadravyas.
Journal Article Review on Rasamanikya
Rasamanikya is a excellent preparation in the field of Rasashastra, it is used in various Kushtha Roga, Shwasa, Vicharchika, Bhagandara, Vatarakta, and Phiranga Roga. In this article Preparation& Comparative analytical profile for both Formulationon i.e Rasamanikya prepared by Kushmanda swarasa & Churnodhaka Shodita Haratala. The study aims to provide insights into the comparative efficacy and analytical aspects of these formulations for enhanced therapeutic outcomes.
Clinic ^%[+27633867063*Abortion Pills For Sale In Tembisa Central
Clinic ^%[+27633867063*Abortion Pills For Sale In Tembisa Central Clinic ^%[+27633867063*Abortion Pills For Sale In Tembisa CentralClinic ^%[+27633867063*Abortion Pills For Sale In Tembisa CentralClinic ^%[+27633867063*Abortion Pills For Sale In Tembisa CentralClinic ^%[+27633867063*Abortion Pills For Sale In Tembisa Central
TEST BANK For An Introduction to Brain and Behavior, 7th Edition by Bryan Kol...
TEST BANK For An Introduction to Brain and Behavior, 7th Edition by Bryan Kol...rightmanforbloodline
TEST BANK For An Introduction to Brain and Behavior, 7th Edition by Bryan Kolb, Ian Q. Whishaw, Verified Chapters 1 - 16, Complete Newest Versio
TEST BANK For An Introduction to Brain and Behavior, 7th Edition by Bryan Kolb, Ian Q. Whishaw, Verified Chapters 1 - 16, Complete Newest Version
TEST BANK For An Introduction to Brain and Behavior, 7th Edition by Bryan Kolb, Ian Q. Whishaw, Verified Chapters 1 - 16, Complete Newest VersionRecently uploaded (20)
Vestibulocochlear Nerve by Dr. Rabia Inam Gandapore.pptx
Vestibulocochlear Nerve by Dr. Rabia Inam Gandapore.pptx
TEST BANK For Community Health Nursing A Canadian Perspective, 5th Edition by...
TEST BANK For Community Health Nursing A Canadian Perspective, 5th Edition by...
Top 10 Best Ayurvedic Kidney Stone Syrups in India
Top 10 Best Ayurvedic Kidney Stone Syrups in India
Hemodialysis: Chapter 4, Dialysate Circuit - Dr.Gawad
Hemodialysis: Chapter 4, Dialysate Circuit - Dr.Gawad
Local Advanced Lung Cancer: Artificial Intelligence, Synergetics, Complex Sys...
Local Advanced Lung Cancer: Artificial Intelligence, Synergetics, Complex Sys...
Post-Menstrual Smell- When to Suspect Vaginitis.pptx
Post-Menstrual Smell- When to Suspect Vaginitis.pptx
CHEMOTHERAPY_RDP_CHAPTER 6_Anti Malarial Drugs.pdf
CHEMOTHERAPY_RDP_CHAPTER 6_Anti Malarial Drugs.pdf
TEST BANK For Basic and Clinical Pharmacology, 14th Edition by Bertram G. Kat...
TEST BANK For Basic and Clinical Pharmacology, 14th Edition by Bertram G. Kat...
REGULATION FOR COMBINATION PRODUCTS AND MEDICAL DEVICES.pptx
REGULATION FOR COMBINATION PRODUCTS AND MEDICAL DEVICES.pptx
Clinic ^%[+27633867063*Abortion Pills For Sale In Tembisa Central
Clinic ^%[+27633867063*Abortion Pills For Sale In Tembisa Central
TEST BANK For An Introduction to Brain and Behavior, 7th Edition by Bryan Kol...
TEST BANK For An Introduction to Brain and Behavior, 7th Edition by Bryan Kol...
Muscular dystrophies
- 2. Duchene Muscular Dystrophy Severe generalized,skeletal muscles, infancy, death by early adult life X – linked recessive, dystrophin, membrane fragility Climbing stairs and arising from floor Pelvifemoral muscles, shoulder Pseudohypertrophy of calf, quadriceps, deltoids Staddles to stand, waddle gait Lordosis, protuberant abdomen,
- 3. Kyphoscoliosis, weakening of respiratory muscles complicates Cardiac muscle Lab; CK, EMG Biopsy: inflammation, central nuclear regeneration, hypercontraction ( type II), segmental necrosis, grouped necrosis
- 7. Becker Less common and severe Weakness and hypertrophy of same muscles 5 – 45 years Reduced dystrophin
- 9. Facioscapulohumeral dystrophy Late childhood or adolescence Difficulty in lifting arms over head Winging of scapula, elevated – angels wing Bifacial weakness,pursed lips, eyelids not closed firmly Popeye effect Bevor sign; flexing the neck – upward movement of umblicus
- 10. Scapuloperoneal Neck,shoulders, upper arms, anterior tibial, peroneal Desmin gene Middle adult life Bilateral foot drop Areflexia, distal sensory loss
- 11. Restricted ocular and oculopharyngeal myopathies Progressive external opthalmoplegia External occular muscles Levator muscles – ptosis, hutchinsonian facies Kearns – sayre syndrome; opthalmoplegia, retinitis pigmentosa, short stature, csf protein Dysphagia Blepharoplasty, cutting pharyngeals mluscle
- 12. Myotonic dystrophy Slight mental retardation Cortical cataract, hypogonadism Thin, narrow face, temporal atrophy, drooping eyelids, thin sternomastoid muscles swan neck, cranial muscle involvement, frontal baldness Weak pharyngeal, laryngeal muscles soft monotonous nasal quality Distal dystrophies, foot drop
- 13. Congenital myotonic dystrophy Mother – myotonia Drooping eyelid, tented upper lip carp mouth Open jaw – hallmark Difficulty in sucking, swallowing Bronchial aspiration Delayed motor and speech development Mental retardation
- 14. Myopathology: long rows of central sarcolemmal nuclei, sarcoplasmic masses, CK EMG; myotonia
- 16. Infectious Trichinosis,toxoplasmosis,cysticercosis,try panosomiasis, Undercooked pork – gastroenteritis Cranial – tongue,masseters, extra occular, pharyngeal Swollen and tender musulature Orbital and facial oedema Complications – myocarditis - embolism
- 17. 3 – 4 weeks Eosinophilia Serum antibodies Moderate rise in ck Muscle biopsy - confirmation Thiabendazole, prednisone
- 18. Idiopathic polymyositis and dermatomyositis Proximal limb, girdle muscles Neck, pharynx and larynx Weakness of the muscles Climbing, squatting, kneeling Lolling of head, dysphagia, dysphonia DM; heliotropic rash Children ; pain, fever intermitent, melana,hematemesis, perforation of gastrointestinal tract Flexion contractures and subcutaneous