DIAGNOSIS CHECKLIST
for Muscle atrophy

Why: to determine if acute or chronic.

Why: Focal muscular atrophy would suggest poliomyelitis, early spinal muscular atrophy, peripheral vascular disease, sympathetic dystrophy, early spinal cord tumor, herniated disc, peroneal muscular atrophy, entrapment syndrome of one of the peripheral nerves, motor neurone disease, multiple sclerosis or syringomyelia.

Why: may be an explanation for the muscle wasting.

Why: muscle or nerve injury may cause muscle wasting.

Why: may suggest Guillain- Barre syndrome.

Why: e.g. diabetes may cause neuropathy and may also have muscle loss from muscle breakdown due to high blood sugars; pernicious anemia may cause subacute combined degeneration of the cord and muscle wasting.

Why: e.g. clofibrate may cause myotonia (an inability to relax muscles after voluntary contraction) and resultant muscle wasting.

Why: e.g. Vitamin B12 deficiency may cause subacute combined degeneration of the cord with muscle wasting.

Why: e.g. dystrophia myotonica, hereditary paramyotonia, Duchenne muscular dystrophy, peroneal muscular atrophy (Charcot-Marie-Tooth disease), osteogenesis imperfecta.

Why: Alcoholism may be complicated by alcoholic neuropathy and consequent muscle wasting.

Why: e.g. wasting and weakness of the thigh and upper arm muscles, enlargement of male breasts, frontal baldness, shrinkage of the testicles, deterioration in vision.

Why: e.g. refusal to maintain normal body weight, loss of more than 25% of original body weight, intense fear of becoming fat, preoccupation with calorie counting, avoidance of all carbohydrate, fainting.

Why: e.g. palpitations, increased heart rate, preference for cooler weather, increased appetite, weight loss, increased sweating, tremor, nervousness, irritability, diarrhea, lack of menstrual periods, frequent urination.

Why: e.g. easy muscle fatigability especially eyelids, neck, shoulders, lower legs and trunk, droopy eyelids, double vision, weak voice.

Why: symptoms are often vague but may include e.g. weight loss, loss of appetite, tiredness, weakness, fever, depression, lack of menstrual periods, impotence, nausea, vomiting, diarrhea, confusion, fainting, abdominal pain, constipation, muscle aches and muscle wasting.

Why: e.g. ataxic gait (clumsy slapping down of the feet), weakness of lower limbs, numbness of feet, reduced vision, dementia.

Why: e.g. affects only males, delayed developmental progress, 50% do not walk before 18 months of age, abnormal gait including toe walking, inability to run normally, difficulty in climbing and in rising from sitting or lying position, frequent falls.

Why: e.g. weakness of distal limb muscles, distal numbness, if more severe may have respiratory and facial muscle weakness. Wasting of muscles in rare but possible.

Why: e.g. paresthesia or "pins and needles" affecting the pulps of the thumb, index , middle and half of the ring finger. These symptoms are usually noticed after, rather than during, rapid use of the hands. There may also be pain, which may radiate up as far as the shoulder, from the inside of the wrist. There may also be muscle wasting and weakness of the hands.

Why: e.g. wasting and weakness of the muscles below the knee, slow progression over many years, variable loss of sensation in lower legs.

Why: e.g. usually starts with the gradual onset of pain and stiffness of the small joints of the hands and feet. Joint pain is worse on waking, nocturnal pain with disturbed sleep, pain is relieved with activity. Morning and rest stiffness can last for hours. May be associated with weakness, weight loss, malaise and fatigue. There is muscle wasting around the affected joints, particularly the hands.