A Young Man With Large and Stiff Muscles
An 18-year-old patient had complained of muscle stiffness since he was 2½ years old, impairing his ability to exercise. He felt less stiff after warming up, and cold made the…
A Woman With Proximal Muscle Weakness and Neuromuscular Irritability
A 67-year-old woman presented with a 6-year history of mild difficulty climbing stairs, rising from a chair, and lifting her grandchild. She denied difficulty swallowing, numbness, shortness of breath, fasciculations,…
A Woman With Focal Spontaneous Muscle Movements
A 42-year-old right-handed, Black woman came complaining that her leg muscles got tight and “moved on their own” for about 4–5 months prior to presentation and had gotten progressively worse….
A Woman With Muscle Cramps and Fasciculations
A 53-year-old woman complained of frequent muscle spasms, cramps, and mild fluctuating weakness in the arms and legs for 6 years. She initially had difficulty rising from a squat position…
A Boy With Short Stature, Small Jaw, Muscle Hypertrophy, and Stiffness
A 5-year-old boy was seen for muscle stiffness. He was the product of a normal pregnancy of a 27-year-old woman and had normal developmental milestones until he developed progressive limb…
An Elderly Woman With Muscle Spasms
An 81-year-old woman with a history of thyroidectomy for thyroid carcinoma presented 2 years later with recurrent muscle spasms, muscle pain, and weakness. Her serum calcium levels were consistently in…
A Woman With Generalized Increased Insertional Activity on EMG
A 41-year-old woman with no past medical history was referred for an EMG because of right shoulder pain. She denies neck pain. There was no family history. She denies stiffness….
A Man With Muscle Stiffness and Later With Diplopia
A 31-year-old, right-handed man presented with left hip and low back spasms which eventually spread to all four limbs and the entire back bilaterally. Neurologic examination showed normal mental status…
A Woman With Painful and Swollen Legs
A 46-year-old woman presented with a 2-month history of progressive fatigue, generalized edema, myalgia, and proximal muscle weakness. She had a 30-lb weight gain, diffuse large joint arthralgias, and morning…
A Man With a Bent Spine
A 65-year-old man developed a sudden onset of nonradiating, severe back pain, and he had to lie down on the floor for several hours. The next day he felt weak…
