Clinical Reasoning: A 45-year-old man with weakness and myalgia after orthopedic surgery
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A 45-year-old man underwent rotator cuff surgery and developed fatigue and generalized myalgia postoperatively. After 4 weeks of mild symptoms, he experienced severe muscle aches and bilateral leg weakness after walking 1.5 miles, prompting him to seek medical attention.Keywords:
myalgia
Muscle weakness
A 45-year-old man underwent rotator cuff surgery and developed fatigue and generalized myalgia postoperatively. After 4 weeks of mild symptoms, he experienced severe muscle aches and bilateral leg weakness after walking 1.5 miles, prompting him to seek medical attention.
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Muscle weakness
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This study examined the feasibility of orthopedic surgeons performing sonography of the shoulder at the initial office evaluation of the rotator cuff and assessed the sensitivity, specificity, and predictive value of sonography for the detection of tears in the rotator cuff. Initial results in 24 patients suggest that sonography by the orthopedic surgeon is feasible and that it detects tears in the rotator cuff with sufficient accuracy for clinical decision making.
Rotator cuff injury
Cuff
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ABSTRACT BACKGROUND: Muscle weakness is a debilitating condition that can lead to frailty, falls, and functional decline. Muscle weakness is found across many diseases; therefore, understanding what constitutes this condition is paramount. The National Library of Medicine provides 2 definitions of muscle weakness, both from a disease perspective. These definitions are narrow and do not account for overlapping causes of muscle weakness. Nurses are holistic practitioners, so they need to understand the clinical characteristics of muscle weakness, regardless of underlying disease processes. METHODS: Secondary analysis of data from an earlier qualitative study. Using content analysis of transcripts of semistructured interviews with a multidisciplinary group of 12 experts in the management of muscle disorders, we identified characteristics of muscle weakness from the clinicians' perspectives. RESULTS: Muscle weakness has characteristics of debility, loss of function, and asymmetry. The characteristics of debility include lack of strength, atrophy, and fatigue. Muscle weakness does coexist with muscle tightness. CONCLUSIONS: The characteristics of muscle weakness identified in our study are markedly different from those included in National Library of Medicine definitions. As a condition, muscle weakness has both subjective and objective traits. Therefore, clinician assessment and patient input combined capture the comprehensive nature of muscle weakness. Nurses' awareness of what constitutes muscle weakness, regardless of diagnosis, is the first step in optimal management of this condition.
Muscle weakness
Debility
Muscle Atrophy
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‘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.
Muscle weakness
Muscle Atrophy
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Background: Progressive muscle weakness without definite etiology is still a diagnostic problem. Hyperparathyroidism is one of the implicated causes of this medical controversy. Objective: This study aims at exploring the role of hyperparathyroidism as a possible cause of unexplained progressive muscle weakness. Methods: Out of 83 patients with progressive muscle weakness screened for parathyroid functions, nine patients proved to have hyperparathyroidism. Patients were evaluated clinically, neurophysiologically and by laboratory assessment ( routine laboratory investigations, and hormonal profile). Muscle biopsy was done in 2 patients. Results: Progressive proximal muscle weakness secondary to hyperparathyroidism was recorded in 9 patients (10.8%), and this weakness is mostly neurogenic with no evidence of myopathic changes. The definite pathophysiologic mechanisms of this weakness is still not clear yet, however, the proposed causes are elevated parathyroid hormone level, hypocalcemia, hypophosphatemia, and decreased vitamin D level. Conclusion: Hyperparathyroidism is a possible treatable cause of progressive muscle weakness, and should be included in the differential diagnosis of patients presenting with unexplained muscle weakness. [Egypt J Neurol Psychiat Neurosurg. 2010; 47(3): 441-445]
Muscle weakness
Etiology
Proximal muscle weakness
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Muscle weakness in the perioperative period is a common finding and is a risk to patient safety. It can occur as a result of many physiological, pathological, and iatrogenic states. The most common etiology is the use of, misuse of, and failure to reverse neuromuscular blocking drugs (NMBDs). Patients might also present with underlying neuromuscular disorders at baseline or in an exacerbated state after surgery and anesthesia. Muscle weakness can lead to critical events such as respiratory failure and can delay recovery and discharge. The plan for prompt diagnosis and management of a patient with muscle weakness is presented. Knowledge of the pathophysiology, assessment, and treatment of perioperative muscle weakness is essential to ensure optimal patient outcomes.
Muscle weakness
Etiology
Neuromuscular Blocking Agents
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The article presents data on the main causes of muscle weakness in children and discusses the clinical features of diseases that may be accompanied by muscle weakness. Emphasis is placed on the possibilities of differential diagnosis of muscle weakness syndrome in children through the use of various methods of examination. The algorithm of differential diagnostic search at muscular weakness is offered. The possibility of its application in pediatric practice is demonstrated on clinical examples. Despite certain common features in the onset of the disease in the presented cases, a detailed examination makes it possible to distinguish between congenital and acquired causes of muscle damage and refer the patient for appropriate treatment. It should be noted that muscle weakness is a fairly common symptom in a child. More often it is not associated with damage to the muscles themselves. The causes of chronic weakness differ significantly in children of all ages. In a child with clinical signs of muscle weakness, it is necessary to conduct a thorough examination, aimed primarily at excluding various serious diseases. The research was carried out in accordance with the principles of the Helsinki Declaration. The informed consent of the patient was obtained for conducting the studies. No conflict of interests was declared by the authors. Key words: children, muscle weakness, differential diagnosis.
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myalgia
Proximal muscle weakness
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We report a rare case that revealed severe myalgia as the chief complaint that is not mentioned in the list of frequent symptoms of Guillain Barré. Guillain-Barré syndrome (GBS) is an acute inflammatory demyelinating polyneuropathy (AIDP).Required features for diagnosis of GBS are progressive motor weakness of more than one limb and areflexia. We report an 11-yearold boy who was referred to the emergency department with complaints of generalized body pain and gate problem. It seems that if myalgias are the chief complaint and weakness is mentioned as a less important symptom, clinicians should consider GBS after ruling out other reasons for myalgia especially inflammatory myositis.
myalgia
Polyradiculopathy
Muscle weakness
Complaint
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Abstract A large proportion of all falls occur because of the combination of impaired balance and weak muscles. Both of these factors become common with increasing age, and usually both are present when someone who has fallen is seen in the clinic. Trying to work out which is the major factor in any individual is often impossible, as they are inextricably linked.Muscle weakness Muscle weakness has many causes: any illness will cause muscle weakness painful joints cause loss of muscle around the joint, with weakness and a tendency for the joint to give way previous injury, surgery, or disability, especially in the legs prolonged immobility causes wasting and weakness? deconditioning—not using the muscles enough—is very common specific neurological conditions such as stroke and neuropathy lead to weakness
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Deconditioning
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