Neuromuscular ultrasound as an initial evaluation for suspected myopathy: A case report

Ebert, Suzahn E.; Brenzy, Kevin; Cartwright, Michael S.

doi:10.1002/mus.26434

Cited by 3 publications

(3 citation statements)

References 10 publications

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“…In this study, we have shown that cDMD have skeletal muscle abnormalities that are detectable using MUS. Such imaging changes were found in muscles with normal strength of the lower limbs, suggesting that MUS may be more sensitive than standard neurological examination to detect neuromuscular involvement in cDMD 20,21 . This is in line with previous reports from boys with DMD, in which quantitative MUS was able to identify muscle abnormalities in toddlers prior to the onset of functional decline 22 …”

Section: Discussionsupporting

confidence: 87%

“…Such imaging changes were found in muscles with normal strength of the lower limbs, suggesting that MUS may be more sensitive than standard neurological examination to detect neuromuscular involvement in cDMD. 20,21 EI (based on gray scale levels) are the MUS-derived parameter most commonly used in neuromuscular disorders. 21 In this study, mean EI values were not different between cDMD and control groups across all muscle groups.…”

Section: Discussionmentioning

confidence: 99%

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Quantitative ultrasonography reveals skeletal muscle abnormalities in carriers of DMD pathogenic variants

Loureiro,

de Brito,

Iwabe

et al. 2024

Muscle and Nerve

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Introduction/AimsCarriers of DMD pathogenic variants may become symptomatic and develop muscle‐related manifestations. Despite that, few studies have attempted to characterize changes in the muscles of these carriers using imaging tools, particularly muscle ultrasound (MUS). The aim of this study was to compare lower limb MUS findings in carriers of DMD pathogenic variants (cDMD) vs healthy controls.MethodsTwenty‐eight women (15 cDMD and 13 controls) underwent clinical evaluation and MUS. We collected information about muscle‐related symptoms and assessed muscle strength. MUS was performed by a single physician (blind to the genetic status of subjects). The following muscles were assessed: rectus femoris, sartorius, tibialis anterior, and medial gastrocnemius. For each site, we computed data on muscle thickness, cross‐sectional area, sound attenuation index, and elastography. Between‐group comparisons were assessed using nonparametric tests and p‐values <.05 were deemed significant.ResultsNone of the subjects had objective muscle weakness, but exercise intolerance/fatigue was reported by four cDMDs and only one control. Regarding MUS, sound attenuation indices were significantly higher among carriers for all muscles tested. Longitudinal and axial deep echo intensities for the rectus femoris and tibialis anterior were also higher in the cDMD group compared with controls. No significant between‐group differences were noted for elastography values, muscle area, or mean echo intensities.DiscussioncDMD have skeletal muscle abnormalities that can be detected using quantitative MUS. Further studies are needed to determine whether such abnormalities are related to muscle symptoms in these patients.

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Section: Discussionsupporting

confidence: 87%

Section: Discussionmentioning

confidence: 99%

Quantitative ultrasonography reveals skeletal muscle abnormalities in carriers of DMD pathogenic variants

Loureiro,

de Brito,

Iwabe

et al. 2024

Muscle and Nerve

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“…This type of abnormality is usually easy to pick up visually when comparing the affected and unaffected limb (Figure 2K). It can help pre‐screen muscles of interest for needle EMG, for example in children or other patients who do not tolerate needling well 34 . The myotomal pattern of muscle involvement as determined by muscle ultrasound can be used to assess mononeuropathies and radiculopathies.…”

Section: Current Possibilities Of Muscle Ultrasoundmentioning

confidence: 99%

Muscle ultrasound: Present state and future opportunities

2020

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Muscle ultrasound is a valuable addition to the neuromuscular toolkit in both the clinic and research settings, with proven value and reliability. However, it is currently not fulfilling its full potential in the diagnostic care of patients with neuromuscular disease. This review highlights the possibilities and pitfalls of muscle ultrasound as a diagnostic tool and biomarker, and discusses challenges to its widespread implementation. We expect that limitations in visual image interpretation, posed by user inexperience, could be overcome with simpler scoring systems and the help of deep‐learning algorithms. In addition, more information should be collected on the relation between specific neuromuscular disorders, disease stages, and expected ultrasound abnormalities, as this will enhance specificity of the technique and enable the use of muscle ultrasound as a biomarker. Quantified muscle ultrasound gives the most sensitive results but is hampered by the need for device‐specific reference values. Efforts in creating dedicated muscle ultrasound systems and artificial intelligence to help with image interpretation are expected to improve usability. Finally, the standard inclusion of muscle and nerve ultrasound in neuromuscular teaching curricula and guidelines will facilitate further implementation in practice. Our hope is that this review will help in unleashing muscle ultrasound's full potential.

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Neuromuscular Ultrasound in the Pediatric Population

VanHorn

Cartwright

2020

Diagnostics

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The diagnosis and evaluation of neuromuscular disorders traditionally involves electrodiagnostic (EDx) testing, including nerve conduction studies (NCSs) and electromyography (EMG). These tools can cause pain and discomfort, an important consideration when performed on children. Neuromuscular ultrasound is noninvasive, cost-effective, and increasingly utilized for the detection of neuromuscular pathology. Studies investigating the performance and clinical implementation of ultrasound have primarily been performed in adult populations. Ultrasound in children has the potential to guide EDx testing and ultimately improve diagnostic efficiency and accuracy. This review aims to describe key features of neuromuscular ultrasound in the pediatric population based on the available studies, including our own institutional experience.

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Neuromuscular ultrasound as an initial evaluation for suspected myopathy: A case report

Cited by 3 publications

References 10 publications

Quantitative ultrasonography reveals skeletal muscle abnormalities in carriers of DMD pathogenic variants

Quantitative ultrasonography reveals skeletal muscle abnormalities in carriers of DMD pathogenic variants

Muscle ultrasound: Present state and future opportunities

Neuromuscular Ultrasound in the Pediatric Population

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