A recent case study authored by members of the department of radiology and a Health Center clinician was published in Journal of Ultrasound. It reported that an 8-year-old patient with Duchenne muscular dystrophy (DMD) displayed increased sonoelastographic measures (hardening) of lower extremity muscles when compared with an age-matched healthy control. The report also demonstrated the value of using sonoelastography, a noninvasive ultrasound technique, to diagnose and monitor the progress of DMD.
The case study, titled “Sonoelastography of the trunk and lower extremity muscles in a case of Duchenne muscular dystrophy,” was written by Stacey Cornelson, DC, DACBR; Ashley Ruff, DC; Muriel Perillat, DC, MS,; and Norman Kettner, DC, DACBR, FICC, professor and chair of the Department of Radiology.
DMD is a rare genetic disorder that causes muscle weakness and reduced tone of the core and lower extremities through replacement of muscle by fibrofatty tissue. Sonoelastography ultrasound can be used to demonstrate changes in the muscle mechanical properties due to fatty replacement and fibrosis. Thus far, the use of ultrasound technology in diagnosing DMD patients has been limited. Muscle biopsy is the standard for histologic diagnosis of DMD, but ultrasound may be a noninvasive and more cost-effective approach to assess muscle changes and response to treatment. A goal of this case report was to add to the growing argument for this approach.
The case study also demonstrated the value of chiropractic care for treating DMD symptoms. The patient came to Dr. Perillat for palliative care of low back and bilateral leg pain and headaches. Among other symptoms, a physical exam revealed a mild waddling gait, bilateral pseudohypertrophy of the calf muscles and abnormal spinal ranges of motion. The patient also required assistance to climb a flight of stairs.
In addition to sonoelastographic ultrasound to assess muscle stiffness and texture, the patient underwent spinal mobilization, kinesiotaping of lower extremity muscles and was also fitted for foot orthotics to ease the abnormal gait. The patient reported pain reduction and some improvement in gait and required less assistance to climb stairs.