The Orthobullets Podcast Pediatrics | Duchenne Muscular Dystrophy
Dec 28, 2025
Explore the complexities of Duchenne muscular dystrophy, including its genetic roots and unique inheritance patterns. Discuss the importance of diagnostic testing, like elevated CPK levels and muscle biopsies. Learn about the clinical signs, such as Gower's sign and calf pseudohypertrophy. Delve into nonoperative treatments and the role of corticosteroids in managing symptoms. Understand scoliosis risks associated with the condition and review surgical options for intervention. It's a comprehensive guide to an impactful topic in pediatric healthcare.
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Typical Clinical Presentation
- Weakness begins proximally (gluteals) and produces waddling gait, toe walking, and difficulty climbing stairs.
- Classic signs include calf pseudohypertrophy, lumbar lordosis, Gower's sign, and preserved reflexes.
Screening And Confirmation Steps
- Use serum creatine kinase as an early screening test because levels are markedly elevated even before symptoms.
- Confirm diagnosis with DNA testing or muscle biopsy showing absent dystrophin when CK is high.
Steroid Therapy To Prolong Ambulation
- Start corticosteroids (prednisone 0.75 mg/kg/day) in 5–7-year-olds to maintain ambulation and slow decline.
- Expect improved strength, delayed scoliosis, and pulmonary benefits but monitor for steroid side effects.