Duchenne muscular dystrophy physical examination

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Fahimeh Shojaei, M.D.

Overview

Physical examination of patients with Duchenne muscular dystrophy is usually remarkable for waddling gait, Tachypnea or bradypnea, decreased chest expansion, lordosis, scoliosis, calf muscle hypertrophy, foot drop, tight heel cord, backward bending of the knee, and muscle atrophy in thighs and buttock.

Physical Examination

Physical examination of patients with Duchenne muscular dystrophy is usually remarkable for waddling gait, Tachypnea or bradypnea, decreased chest expansion, lordosis, scoliosis, calf muscle hypertrophy, foot drop, tight heel cord, backward bending of the knee, and muscle atrophy in thighs and buttock.

Appearance of the Patient

• Patients with Duchenne muscular dystrophy usually have waddling or Trendelenburg gait

Vital Signs

• Hyperthermia may be present mostly due to respiratory infections
• Irregularly pulse may be present
• Tachypnea at first due to hypercapnea and bradypnea after respiratory muscle exhaustion

Skin

• Skin examination of patients with Duchenne muscular dystrophy is usually normal

HEENT

• HEENT examination of patients with Duchenne muscular dystrophy is usually normal

Neck

• Neck deviation may be present

Lungs

• Decreased chest expansion
• Use of accessory breath muscles
• Decreased breath sounds may be seen in case of pneumonia
• Fine/coarse crackles upon auscultation of the lung may be present in case of pneumonia

Heart

• Arrythmia may be present.

Abdomen

• Abdomen sticks out because of the lordosis

Back

• Scoliosis
• Abnormal spinal curves (specially lordosis)

Genitourinary

• Urinary dysfunction may be present

Neuromuscular

• Patient is usually oriented to persons, place, and time
• Hyporeflexia / areflexia may be present
• Muscle weakness specially in the lower limbs
• Waddling gait
• Gowers sign

Extremities

• Calf muscle hypertrophy
• Foot drop
• Tight heel cord
• Backward bending of the knee
• Muscle atrophy in thighs and buttock