The role of muscle ultrasound in helping the clinical diagnosis of muscle diseases

Abstract

Background: Selective involvement of certain muscles is an indicator for muscle diseases and helps to direct the diagnosis, but in some cases, it cannot be detected clinically; hence, the roles of muscle MRI and ultrasound are to detect this selectivity and facilitate the diagnosis.

Objectives: The possibility of using muscle ultrasound as a screening tool when muscle diseases are suspected and as an alternative to MRI.

Subjects and methods: This cross-sectional descriptive study included 38 patients presented with clinical manifestations suggestive of muscle diseases. The patients were selected over a period of 1 year. All patients were subjected to thorough clinical assessment and muscle ultrasound of the thigh and leg for all patients, while 15 were subjected to MRI. Clinical and radiological assessments were performed separately, followed by both clinical and radiological findings to assess the power of combining the clinical and radiological assessments for the diagnosis of muscle diseases.

Results: The clinical assessment reached a main provisional probable diagnosis in 53% cases, and radiological assessment blind to clinical data suggested diagnosis in 18 of the total cases, while the combination of both ultrasound and MRI could suggest diagnosis in 87% of the cases. The concordance ratio of ultrasound to MRI ranged between 78 and 100%.

Conclusion: The combination of clinical and radiological assessments of muscle diseases can suggest a main provisional probable diagnosis, especially when genetic diagnosis is not accessible, or to direct the genetic testing when it is available. Ultrasound can be used as a routine tool in screening and follow-up of muscle diseases.

Keywords: Muscle MRI; Muscle ultrasound; Myopathy.

Conflict of interest statement

The Ethical Committee of the Faculty of Medicine, Cairo University, has allowed this study. The date of approval was on 16 December 2013, and final approval of the whole work was on 13 July 2015, but the reference number of approval is not available.The aim and whole procedure were explained for every patient. Patients signed an informed consent before the beginning of the study to insure complete satisfaction. Not applicable.The authors declare that they have no competing interests.Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1

In patient with LGMD2B, ultrasound detected preferential affection of both heads of biceps brachii

Fig. 2

Muscle ultrasound in patient with limb girdle muscular dystrophy 2A (LGMD2A) showing in the thigh more affection of posterior compartment with predominant affection of the adductors, in the leg more affection of medial head of gastrocnemius (MED GASTRO) and soleus (SOL) more than lateral head with relative sparing of tibialis anterior (TA)

Fig. 3

Muscle ultrasound in patient with X-linked recessive Emery-Dreifuss muscular dystrophy (EDMD) showing minimal affection in the thigh especially of the vastus lateralis (VL) and vastus intermedius (VI) and in leg selective affection of soleus

Fig. 4

Muscle ultrasound in patient suspected to be with acid maltase deficiency showing affection of the vastus intermedius (VI) and sparing of the rectus femoris (RF) and vastus lateralis (VL) and affection of the vastus medialis (VM) with sparing tibialis anterior (TA)