RT Book, Section
A1 Friedman, Neil
A2 Usatine, Richard P.
A2 Sabella, Camille
A2 Smith, Mindy Ann
A2 Mayeaux, E.J.
A2 Chumley, Heidi S.
A2 Appachi, Elumalai
SR Print(0)
ID 1114879995
T1 Duchenne Muscular Dystrophy
T2 The Color Atlas of Pediatrics
YR 2015
FD 2015
PB McGraw-Hill Education
PP New York, NY
SN 978-0-07-176701-9
LK accesspediatrics.mhmedical.com/content.aspx?aid=1114879995
RD 2022/08/20
AB A  9-year-old  boy  with  a  history  of  Duchenne  muscular  dystrophy  (DMD)  is  being  seen  by  his  pediatrician  for  a  routine  maintenance  exam.  He  initially  presented  at  3  years  of  age  for  evaluation  of  toe  walking  and  excessive  falling,  and  was  diagnosed  with  DMD.  He  started  walking  independently  between  12  to  14  months  of  age.  He  had  always  been  slower  than  his  peers  and  has  difficulty  keeping  up  with  them.  At  the  time  of  diagnosis,  the  family  reported  increasing  difficulty  going  up  steps  which  he  can  only  do  one  step  at  a  time.  He  also  had  difficulty  getting  up  from  the  floor,  needing  to  push  on  his  knee  or  use  furniture  for  assistance  (Gower  sign),  which  has  continued  and  is  pronounced  at  the  current  visit  (Figure  208-1).  He  also  tends  to  be  clumsy  with  excessive  falling  and  has  an  awkward  appearing  waddling  gait,  exacerbated  by  running.