Self-Assessment: Muscle US: Quantitative Assessment & Patterns of Muscle Involvement | Gait Analysis & Orthotics for NMDs-Muscle US: Quantitative Assessment & Patterns of Muscle Involvement: Dr. Meiling Presentation

Muscle US: Quantitative Assessment & Patterns of Muscle Involvement: Dr. Meiling Presentation

Pdf Summary

The clinical presentation led by Dr. James B. Meiling examines the significant utility of neuromuscular ultrasound (NMUS) as an adjunctive tool in electromyography (EMG) labs, emphasizing its role alongside traditional electrodiagnostic (EDX) techniques rather than replacing them. Through a case-based learning approach, various scenarios are explored to illustrate NMUS’s practical applications in diagnosing muscle disorders.<br /><br />**Case summaries include:**<br /><br />1. A 74-year-old male with hand weakness whose NMUS and EDX findings suggested Inclusion Body Myositis, evidenced by hyperechoic and atrophic muscle changes, complemented by elevated CK levels and NT5C1A antibodies.<br /><br />2. A 45-year-old female presenting with proximal muscle weakness linked to her atorvastatin use, diagnosed with Inflammatory Myopathy. NMUS identified changes in muscle echogenicity supportive of concurrent EDX findings.<br /><br />3. Quickfire cases showcasing congenital anomalies include abnormal presentation of the palmaris longus and the flexor carpi ulnaris, and detection of accessory muscles, primarily asymptomatic but occasionally causing nerve entrapments.<br /><br />4. A 66-year-old male with chronic left shoulder weakness due to an ancient injury benefited from ultrasound-guided EMG for precise diagnosis of a non-localizable chronic axillary mononeuropathy.<br /><br />5. A 75-year-old female with breathing difficulties was diagnosed using NMUS with bilateral hemidiaphragm paralysis, with absent phrenic nerve responses leading to suspicion of a neurogenic disorder like motor neuron disease.<br /><br />6. A pediatric case of a 16-month-old with a gait abnormality owing to lumbar myelomeningocele revealed NMUS’s advantage in pediatric diagnostic settings; it is painless and allows detailed lesion investigation.<br /><br />The presentation emphasizes the role of NMUS in identifying structural abnormalities, guiding muscle biopsy, aiding precise EMG needle placement, and addressing pediatric cases—all while underscoring its importance in clinical diagnosis through detailed muscle visualization. Dr. Meiling concludes by inviting feedback and providing contact information for further inquiries on the use of NMUS in medical education and practice.

Keywords

neuromuscular ultrasound

electromyography

EMG

muscle disorders

case-based learning

Inclusion Body Myositis

Inflammatory Myopathy

congenital anomalies

axillary mononeuropathy

bilateral hemidiaphragm paralysis

pediatric diagnostics

EMG

electromyography