How to Diagnose Muscle Atrophy

Muscular atrophy causes a progressive weakening of muscle tissue that can lead to paralysis and even death. One type, disuse muscular atrophy, appears more commonly in adults over 50 who do not use their muscles enough. Doctors treat this type with exercise, ultrasound therapy and sometimes surgery. More serious and rare is spinal muscular atrophy, which affects four out of every 100,000 infants. SMA victims do not survive past early adulthood because there is no known treatment for the condition.

Instructions

Disuse Muscular Atrophy

• 1

  Have patients describe symptoms, stating when the pain started, how long it lasts and whether it is worsening. Ask if patients feel discomfort in muscles that seem unrelated to the symptoms. For example, a patient who reports arm weakness might not realize that the difficultly he is having breathing could indicate atrophy of the chest muscles.

• 2

  Ask patients about past medical conditions and family medical history. As Medline Plus suggests, doctors should know if the patient consumes too much alcohol, suffers from rheumatoid arthritis or has had a stroke or spinal-cord injury, all known causes of muscular atrophy.

• 3

  Perform a physical examination to measure the patient's limb circumference. Observe whether the patient's gait is normal. Test for range of motion by having the patient extend his muscles fully. Note which movements cause pain.

• 4

  Test the patient's muscle strength by having the patient push against you. Rate the strength on a scale from 0 to 5, with 5 being normal and 0 indicating no movement.

• 5

  Have the laboratory perform a complete blood count to rule out blood disorders. Order additional tests to ensure the muscles are not inflamed and have normal levels of enzymes and electrical activity.

Spinal Muscular Atrophy

• 6

  Request the child's medical records through age 2. Look for risk factors, such as a family history of SMA, weak shoulder and leg muscles, and frequent respiratory infections.

• 7

  Ask the parents if the child has difficulty with feeding or breathing. Find out if the child loses control of movement of his head, characterized by the inability to lift the head, move it from side to side and hold it steady by the age of 6 months, and if symptoms are worsening.

• 8

  Have the parents narrate the child's physical development. Find out whether the child learned to sit and walk independently at a normal age.

• 9

  Examine the child for SMA indicators such as poor posture and nasal speech. Look for signs of neuromuscular disease, such as "floppy" muscles, lack of deep tendon reflexes and twitching in the tongue. Confirm that weakness appears in the proximal (central) muscles in the arms and legs.

• 10

  Perform other genetic tests to determine the presence of malfunctioning genes. Recommend the child undergo EMG testing if genetic tests are negative. Read EMG results to make sure muscle nerves carry electrical messages at the right pace. If EMG results are positive, order an MRI to view muscles in detail.