1. Muscular Diseases!
MR. IM

2. 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

3. 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

4. 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

5. 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.

6. 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

7. Treatment Symptoms-based treatment: Physical Therapy
Occupational Therapy
Regular Exercise

8. Carpal Tunnel Syndrome: What is It?
Repeatedly occurring numbness, tingling, burning or pain in fingers and wrist upon pronation/supination, flexion/extension, opposition etc.

9. 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

10. 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

11. 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.

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

13. Treatment Immunosuppressant drugs
Drugs that stop the breakdown of acetylcholine (ACh) aka Acetylcholinesterase inhibitors
Surgery on thymus

14. 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)

15. Causes Often made worse by exercise and triggered by stress.
Over-stretching or fatigue
Overuse

16. Treatment Anti-inflammatory drugs (Advil) physical therapy
RICE with gradual return to exercise

17. Pyomyositis: What is It?
Fever, muscle pain, pus-filled abscesses in the muscles, fatigue
Common in tropical areas

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

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

20. 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

21. Causes Unknown. Genetic component. Stress-related.
Associated with depression.
Most theories deal with neurotransmitters.

22. 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

23. 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.

24. 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…