Further observations on forearm flexor weakness in inclusion body myositis

Felice, Kevin J.; Relva, Gretchen M.; Conway, Stephen

doi:10.1002/(sici)1097-4598(199805)21:5<659::aid-mus17>3.0.co;2-q

Cited by 23 publications

(21 citation statements)

References 10 publications

(8 reference statements)

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“…Delayed diagnosis (average time 5.2 years) [10,20] and misdiagnosis [14] are common. Quadriceps muscle weakness, resulting in difficulty walking and knee buckling, and finger flexor weakness (commonly worse on the nondominant side [10,21]) resulting in grip impairment, are distinctive features. Greater reliance on muscle biopsy features relative to clinical features contributes to misdiagnosis, with weakness of finger flexors, especially flexor digitorum profundi, often overlooked.…”

Section: Clinical Featuressupporting

confidence: 89%

Pathogenesis and therapy of inclusion body myositis

Greenberg

2012

Current Opinion in Neurology

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Section: Clinical Featuressupporting

confidence: 89%

Pathogenesis and therapy of inclusion body myositis

Greenberg

2012

Current Opinion in Neurology

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“…Seven of these studies were retrospective and based on review of the medical records [2,7,12,16,20,22] including one reporting the clinical findings in 18 patients examined by one single investigator [15]. Only two of the nine studies, describing up to 18 patients were cross-sectional in design [13,18].…”

Section: Introductionmentioning

confidence: 99%

“…In the largest study so far the most severely affected muscle groups in cranio-caudal order were the biceps, triceps, iliopsoas, quadriceps and anterior tibial muscles [16]. By contrast, later studies revealed the finger flexors to be most severely affected, along with the knee extensors and foot dorsiflexors [12,13,15,18].With regard to the least affected muscles each study showed a different pattern [13,18].…”

Section: Introductionmentioning

confidence: 99%

Inclusion body myositis

et al. 2005

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The clinical features of inclusion body myositis (IBM) were of minor importance in the design of consensus diagnostic criteria, mainly because of controversial views on the specificity of signs and symptoms, although some authors reported "typical" signs. To re-assess the clinical spectrum of IBM, a single investigator using a standard protocol studied a cohort of 64 patients cross-sectionally. Symptom onset was before the age of 50 years in 20% of cases. Only a few patients (14 %) started with weakness other than that of quadriceps, finger flexor or pharyngeal muscles. The sequence of power loss was erratic, but onset of symptoms with quadriceps weakness predicted an earlier onset of dysphagia in older patients (> or = 56 years) compared with younger ones (< 56 years) (p = 0.02). Despite widespread weakness patients had favourable scores on three commonly used function scales and they kept their employment. Complete wheel-chair dependency was rare (3 %). A dominant characteristic was the anatomical distribution of afflicted muscles: ventral extremity muscle groups were more affected than dorsal muscle groups and girdle muscles were least affected, the latter preserving postural stability. Ankylosis, especially in extension of the fingers,was frequently present. Together with the sparing of intrinsic hand muscles it was helpful in the preservation of many skillful movements. IBM has a unique distribution of muscle weakness. Ankylotic contractures are common. We feel that their joint impact on daily functioning is characteristic for the disease.

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“…Although patients with inclusion body myositis generally present with falls—reflecting quadriceps weakness—it is often the upper limb distal weakness that provides the tell-tale clue to the diagnosis. There is striking loss of grip strength with forearm finger flexor atrophy that is almost always worse in the non-dominant forearm; people might mention that their watch strap has become loose 3. The thenar and hypothenar muscles are preserved, in contrast with their prominent atrophy and weakness in neurogenic conditions.…”

Section: Chameleon Presentationsmentioning

confidence: 99%

Muscle diseases: mimics and chameleons

Walters

2014

Pract Neurol

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Muscle diseases are not as common as headaches and funny turns in our general neurology clinics, but most of us will encounter them. We all pride ourselves on a methodical approach to clinical problems-discovering the where and what in neurological parlance-but any diagnostic process can unravel, particularly if one condition resembles another. Before we settle on a diagnosis, we need to ask ourselves, whether the 'ducks all line up' to avoid cases of mistaken identity.

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Further observations on forearm flexor weakness in inclusion body myositis

Cited by 23 publications

References 10 publications

Pathogenesis and therapy of inclusion body myositis

Pathogenesis and therapy of inclusion body myositis

Inclusion body myositis

Muscle diseases: mimics and chameleons

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