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Muscle atrophy is the wasting, thinning, or loss of muscle tissue, which can cause a decrease in strength. It can be caused by not using the muscles enough, nerve problems, or diseases. To test for muscle atrophy, a healthcare provider will perform a physical exam and ask about symptoms, family history, and lifestyle. They will also measure muscle mass in the arms and legs. Further tests may include blood tests, muscle or nerve biopsies, electromyography (EMG), nerve conduction studies, CT scans, and MRI scans.
| Characteristics | Values |
|---|---|
| Definition | Loss, thinning, or wasting of muscle tissue or mass |
| Loss of muscle strength | 20-40% |
| Causes | Malnutrition, age, genetics, lack of physical activity, nerve problems or diseases, certain medical conditions |
| Types | Physiologic atrophy, pathologic atrophy, neurogenic atrophy |
| Symptoms | Tingling, numbness, weakness in arms and legs, difficulty in speaking or swallowing |
| Diagnosis | Physical examination, family history, blood test, muscle biopsy, electromyography, nerve conduction studies, MRI scan, genetic testing |
| Treatment | Exercise, healthy diet, physical therapy, ultrasound therapy, surgery |
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What You'll Learn
Physical examination
During the physical examination, the healthcare provider will look for signs of muscle wasting or thinning, which can manifest as a decrease in muscle mass and strength. They may compare the muscles in the affected area with those in a healthy part of the body to identify any differences in size or appearance. For instance, muscle atrophy in the arms or legs may result in a noticeable reduction in size or weakness when compared to the unaffected side.
In addition to visual inspection, the physical examination may include simple tests to evaluate muscle strength and function. This can involve assessing the patient's ability to perform certain movements or exercises to identify any limitations or weaknesses. The provider may also palpate the muscles to feel for any tenderness, dermal lesions, or other abnormalities.
For suspected cases of spinal muscular atrophy (SMA), a specific type of muscle atrophy, the physical examination will focus on identifying signs and symptoms indicative of this condition. This includes evaluating muscle weakness, hypotonia (reduced muscle tone), motor difficulties, loss of motor skills, proximal muscle weakness, hyporeflexia (absence of reflexes), tongue fasciculations (involuntary twitches), and signs of low motor neuron disease. SMA is a genetic condition, so a detailed family history is also crucial in the diagnosis.
Overall, the physical examination serves as an essential tool for healthcare providers to gather information, make observations, and perform initial assessments, which, along with the patient's medical history, can aid in formulating a diagnosis and determining the appropriate course of action for managing muscle atrophy.
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Blood tests
Genetic testing is another type of blood test that can be used to identify the cause of muscle atrophy. Genetic tests aim to identify the faulty gene causing the condition and the precise nature of the genetic fault, or mutation. For example, muscular dystrophy is caused by an absence or dysfunction of a protein called dystrophin, which can be identified through blood testing. In addition, since muscular dystrophy is a hereditary condition, genetic testing may be done on the patient and their parents to determine if the specific dystrophin gene is present on the X chromosome. This can confirm a diagnosis of muscular dystrophy.
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Muscle biopsy
During the procedure, the patient is asked to remove their clothing and is given a gown to wear. The skin over the biopsy site is cleaned with an antiseptic solution, and a local anaesthetic is injected to numb the area. If a larger sample is required, a small incision is made in the skin, and sections of muscle tissue are cut using small, sharp scissors or a biopsy needle. The patient may feel a mild discomfort when the muscle is cut. Once the sample is collected, the healthcare provider will apply pressure to the biopsy site to stop any bleeding, and close the opening with adhesive strips or stitches. The sample is then sent to a lab for examination.
Before the procedure, the patient may be given a sedative to help them relax. However, this may cause drowsiness, so patients need to arrange for someone to drive them home. The healthcare provider may also request other specific preparations based on the patient's health condition. After the procedure, it is important to keep the biopsy area clean and dry, and follow the specific bathing instructions provided by the healthcare provider.
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Nerve conduction studies
In a nerve conduction study, the patient may experience sensations similar to mild electric shocks as the speed of signal transmission along their nerves is assessed. This test provides valuable information about the health of the peripheral nervous system, which comprises nerves outside of the brain and spinal cord.
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Imaging techniques
Magnetic resonance imaging (MRI) is a powerful imaging technique for visualizing muscles, organs, the brain, and the spinal cord. It is often used as a diagnostic tool for several health conditions, including muscle atrophy. MRI scans can provide detailed images of muscles and joints, helping doctors make a diagnosis.
MRI is considered the reference imaging method to assess the morphology of muscles, especially in athletes, due to its capability to visualize soft tissues with excellent contrast and provide high-resolution, multiplanar assessments. It is also useful in ruling out other conditions that may cause similar symptoms to muscle atrophy. MRI scans can track treatment progress and help determine optimal sites for muscle biopsies.
Advanced MRI techniques, such as whole-body MRI, quantitative MRI, and multivoxel magnetic resonance spectroscopy (MRS), have enhanced the evaluation and tracking of muscle atrophy and fatty infiltration in muscular dystrophies. These techniques can assess muscle function, composition, microstructure, and elasticity. For example, T2 mapping can demonstrate early fatty atrophy, and diffusion-tensor imaging (DTI) can assess muscle microstructure and integrity.
Ultrasound is another imaging modality that can help visualize muscle abnormalities and atrophy due to root, plexus, and nerve lesions. It is considered as sensitive as manual muscle testing and electromyography (EMG) in detecting muscle involvement. However, large studies comparing its sensitivity and specificity to EMG are not yet available.
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Frequently asked questions
Muscle atrophy is the wasting, thinning, or loss of muscle tissue and mass. This can be caused by disuse of muscles or neurogenic conditions.
If you have muscle atrophy in your limbs, you may feel tingling, numbness, or weakness in your arms and legs. If the atrophied muscles are in your face or throat, you may experience difficulty in speaking or swallowing.
Diagnosis of muscle atrophy begins with a physical examination and a detailed family history. Doctors will look at your arms and legs and measure your muscle mass. They may also order tests such as blood tests, muscle or nerve biopsies, and imaging scans.
There are three main types of muscle atrophy: physiologic, pathologic, and neurogenic. Physiologic atrophy is caused by not using the muscles enough, while pathologic atrophy is associated with aging, starvation, or diseases. Neurogenic atrophy is the most severe form, resulting from nerve injuries or diseases.
Treatment for muscle atrophy depends on the type. Physiologic atrophy can often be reversed with exercise and improved nutrition. Treatment options for other types may include physical therapy, ultrasound therapy, or surgery.
