MUSCULAR DISEASES!MR. IM

Acute Anterior Compartment Syndrome: What is it?

Pressure build-up in anterior compartment of lower leg, specifically between the tibialis anterior muscle, the relatively inelastic fascia (epimysium), consisting of a dense fibrous layer of connective tissue, and the tibia and fibula.

Ischemia (cut-off of blood supply, and thus oxygen & glucose) of blood vessels and nerves, with subsequent necrosis (tissue death)

Associated with swelling of affected area, pain, muscle tightness and tenderness, and stretched skin appearing glossy and hot

Inability to perform dorsiflexion of feet, difficulty walking

Causes

Intracompartmental pressure leads to ischemia—cut-off of blood supply, and thus oxygen & glucose—of blood vessels and nerves, with subsequent necrosis (tissue death)

Often caused by a direct force of impact to area, muscle tear, or skeletal fracture

Treatments

Depending on severity: Steroids/NSAIDS

(Ibuprofen) to treat inflammation

Ice pack to reduce swelling

Surgical incision of anterior leg compartment to relieve pressure (fasciotomy)

Paralysis/Amputation if not treated in time

Muscular Dystrophy: What is It?

Muscles become very weak, break down, and are replaced with fat deposits (atrophy)

Associated with scoliosis, movement difficulty, and muscle deformation

Can on-set at any age and progress quickly or slowly.

Causes

Genetic. Varies based on specific gene affected resulting in a particular dystrophy

Malfunction in creating the dystrophin protein, which is involved in connecting actin to the sarcolemma / sarcoplasmic reticulum and regulating calcium levels

Treatment

Symptoms-based treatment: Physical Therapy Occupational

Therapy Regular Exercise

Carpal Tunnel Syndrome: What is It?

Repeatedly occurring numbness, tingling, burning or pain in fingers and wrist upon pronation/supination, flexion/extension, opposition etc.

Causes

Inflammation of the flexor and extensor retinaculum (tendons proximal to wrist which form a “tunnel” for median nerve to pass through to innervate phalanges I-IV (thumb-ring finger). Inflammation leads to pressure being exerted on the median nerve, possible lesions

Obesity, arthritis, and frequent, repetitive motion can contribute to symptoms

Treatment

Anti-inflammatory drugs Bracing & Occupational Therapy/PT Surgery to cut ligaments/tendons of carpal

tunnel to create space/relieve pressure from inflammation

Corticosteroid injections Stem cell therapy

Myasthenia Gravis: What is It?

Muscle fatigue that gets better with rest but worse with activity.

Fine motor muscles in the face (eyelids, facial expressions, talking, swallowing) are most common but it will also affect limbs.

Causes

Autoimmune disorder where the antibodies attack the acetylcholine receptors in the muscle membrane.

Treatment

Immunosuppressant drugs Drugs that stop the breakdown

of acetylcholine (ACh) aka Acetylcholinesterase inhibitors

Surgery on thymushttps://www.youtube.com/watch?v=2NEjf347Xpk

Tendinitis: What is It?

Pain, stiffness, swelling, or burning sensation around a joint. Tendons connect muscles to bone.

Common in Achilles tendon (ankle) and Patellar tendon (knee)

Causes

Often made worse by exercise and triggered by stress.

Over-stretching or fatigue Overuse

Treatment

Anti-inflammatory drugs (Advil)

physical therapyRICE with gradual return to exercise

Pyomyositis: What is It?

Fever, muscle pain, pus-filled abscesses in the muscles, fatigue

Common in tropical areas

Causes

Bacterial infection of the skeletal muscles (often the gluts and quads), most often by Staphylococcus aureus

Treatment

The abscess within the muscles must be drained surgically and then treated with antibiotics.

Fibromyalgia: What is It?

Chronic, widespread tendon/muscle tenderness

Heightened pain in response to touch

Sleep disturbance/chronic fatigue

Muscle twitching Must last at least three

months and fail “pressure points test”

Most common in women aged 20 to 50 years old

Causes

Unknown. Genetic

component. Stress-related. Associated with

depression. Most theories deal

with neurotransmitters.

Treatment

Exercise/Physical Therapy Cognitive-behavioral therapy Stress-Relieving Techniques Antidepressants Anti-seizure Medications Drugs to treat pain symptoms:

pain relievers, muscle relaxants, sleep aids

Steroid Usage - What is it? Steroids mimic the shape and effects

of the hormone testosterone and stimulate the growth of protein (actin & myosin) in the muscles. More muscle fibers mean bigger muscles.

Risks

Kidney problems, liver problems, baldness, sterility, mood swings, acne, testicular atrophy, high cholesterol levels, high blood pressure, cardiovascular issues etc.

Treatments: Stop taking steroids…