The Contribution of Reflex Inhibition to Arthrogenous Muscle Weakness

1984 ◽  
Vol 67 (1) ◽  
pp. 7-14 ◽  
Author(s):  
Maria Stokes ◽  
Archie Young

‘Arthrogenous muscle weakness’ is weakness of muscles acting about an injured or inflamed joint. The weakness may be due to loss of muscle or to inability to activate the muscle (Fig. 1). Weakness of the thigh muscles, and of the quadriceps in particular, is a common and important consequence of knee trauma, surgery or arthritis. Muscle weakness contributes significantly to disability and probably also renders the joint vulnerable to further damage (Fig. 1). This review starts with a brief discussion of the contribution of atrophy to weakness. It concentrates, however, on inhibition of quadriceps activation and suggests some therapeutic implications. It does not deal with the reduced oxidative capacity and increased fatiguability of disused muscle since, although important, these have not been part of our programme of work.

2020 ◽  
Vol 105 (5) ◽  
pp. e2039-e2049
Author(s):  
Luciana Martel-Duguech ◽  
Alicia Alonso-Jiménez ◽  
Helena Bascuñana ◽  
Jordi Díaz-Manera ◽  
Jaume Llauger ◽  
...  

Abstract Context Muscle weakness is common in patients with Cushing’s syndrome (CS) and may persist after the resolution of hypercortisolism. Intramuscular fatty infiltration has been associated with the deterioration of muscle performance in several conditions. Objectives To quantify the degree of fatty infiltration in the thigh muscles of “cured” CS patients and evaluate the relationship between intramuscular fatty infiltration and physical performance. Design This was a cross-sectional study. Setting Tertiary referral center. Patients Thirty-six women with CS in remission, and 36 controls matched for age, BMI, menopausal status, and level of physical activity. Main Outcome Measures We analyzed the percentage fat fraction (FF) of the thigh muscles in the anterior, posterior, and combined anterior and posterior compartments using MRI and 2-point Dixon sequence. We assessed muscle function and strength using the following tests: gait speed (GS), timed up and go (TUG), 30-second chair stand, and hand grip strength. Results Fat fraction in all the compartments analyzed was increased in patients as compared with controls. The performance on TUG, 30-second chair stand, and GS was more impaired in CS patients versus controls. In patients, greater FF was negatively associated with performance on functional tests. Fat fraction in the combined anterior and posterior compartments predicted performance on TUG (ß 0.626, P < 0.000) and GS (ß -0.461, P = 0.007), after adjusting for age, BMI, menopausal status, and muscle mass. Conclusions Thigh muscle fatty infiltration is increased in “cured” CS patients and is associated with poorer muscle performance. Future studies are needed to establish therapeutic strategies to improve muscle weakness in these patients.


2021 ◽  
pp. 875647932110126
Author(s):  
Yang Yang ◽  
Tony Y. Li

A venous aneurysm (VA) in a calf muscle is extremely rare. In this case study, a primary medial gastrocnemius vein aneurysm (MGVA) with thrombosis is reported. A female patient presented with left medial knee pain for 2 weeks. Radiograph demonstrated severe osteoarthritis of the medial compartment of the left knee. Sonography of the knee incidentally detected a focal saccular dilation in one of the gastrocnemius veins, within the medial head of the gastrocnemius (MHG). The diameter of the dilation was almost three times its connected normal vein. Two-thirds of the saccular dilation was occupied by hyperechoic content. Duplex sonography confirmed that the dilation was a saccular MGVA with thrombosis. The patient had no history of knee trauma, surgery, or inflammation. A small Baker’s cyst, medial to the MHG, was also excluded from the cause of the MGVA. These suggest that this MGVA was of a primary cause. The complications of a MGVA are briefly discussed as part of this case study.


1989 ◽  
Vol 7 (4) ◽  
pp. 263-276 ◽  
Author(s):  
Matthew C. Morrissey

2020 ◽  
Vol 8 ◽  
pp. 2050313X2098412
Author(s):  
Darosa Lim ◽  
Océane Landon-Cardinal ◽  
Benjamin Ellezam ◽  
Annie Belisle ◽  
Annie Genois ◽  
...  

Anti-3-hydroxy-3-methylglutaryl-coenzyme A reductase (HMGCR) immune-mediated necrotizing myopathy is a subtype of idiopathic inflammatory myopathy which may be associated with statin exposure. It presents with severe proximal muscle weakness, high creatine kinase levels and muscle fiber necrosis. Treatment with intravenous immunoglobulins and immunosuppressants is often necessary. This entity is not commonly known among dermatologists as there are usually no extramuscular manifestations. We report a rare case of statin-associated anti-HMGCR immune-mediated necrotizing myopathy with dermatomyositis-like cutaneous features. The possibility of anti-HMGCR immune-mediated necrotizing myopathy should be considered in patients with cutaneous dermatomyositis-like features associated with severe proximal muscle weakness, highly elevated creatine kinase levels and possible statin exposure. This indicates the importance of muscle biopsy and specific autoantibody testing for accurate diagnosis, as well as significant therapeutic implications.


Diagnostics ◽  
2021 ◽  
Vol 11 (11) ◽  
pp. 2064
Author(s):  
Sunha Park ◽  
Dae-Hyun Jang ◽  
Jae-Min Kim ◽  
Nara Yoon

Immune-mediated necrotizing myopathy, a new subgroup of inflammatory myopathies, usually begins with subacute onset of symmetrical proximal muscle weakness. A 35-year-old male presented with severe asymmetric iliopsoas atrophy and low back pain with a previous history of left lower extremity weakness. Although his first left lower extremity weakness occurred 12 years ago, he did not receive a clear diagnosis. Magnetic resonance imaging of both thigh muscles showed muscle edema and contrast enhancement in patch patterns, and the left buttock and thigh muscles were more atrophied compared to the right side. Serum creatine kinase levels were elevated, and serologic testings were all negative. Genetic testing using a targeted gene-sequencing panel for neuromuscular disease including myopathy identified no pathogenic variants. Muscle biopsy on the right vastus lateralis showed scattered myofiber necrosis with phagocytosis and an absence of prominent inflammatory cells, consistent with seronegative necrotizing myopathy. Thus, unusual asymmetric muscle weakness and atrophy can be a manifestation of inflammatory myopathy.


2003 ◽  
Vol 2 (1) ◽  
pp. 29-30
Author(s):  
A GARNIER ◽  
D FORTIN ◽  
C DELOMENIE ◽  
I MOMKEN ◽  
V VEKSLER ◽  
...  

Sign in / Sign up

Export Citation Format

Share Document