Interosseous and thenar muscle atrophy

Introduction Usually with small muscle weakness in the hand and muscle gradual atrophy, it can spread to one side or both sides, or from one side to the opposite side. Due to the atrophy of the size of the fish muscles, the palms are flat, and the interosseous muscles are atrophied and have claw-like hands. Muscle atrophy is extended upwards, gradually invading the forearm, upper arm and shoulder strap. Muscle twitching is common and can be limited to certain muscle groups or widespread, and it is easier to induce by hand tapping. A small number of amyotrophic muscle weakness can be initiated from the tibialis anterior and tibialis musculature of the lower extremities or from the extensors of the neck, and individually from the proximal muscles of the upper and lower extremities.

Cause

Lack of vitamin D, etc., small muscle weakness in the hands and muscles gradually shrinking onset.

an examination

Related inspection

Muscle tone test thumb extensor muscle strength test electromyogram

The small muscles of the hand are weak and the muscles are gradually shrinking.

Differential diagnosis

Spinal muscular atrophy: spinal muscular atrophy (SMA) refers to a type of disease that causes muscle weakness and muscle atrophy due to degeneration of the anterior horn cells of the spinal cord. First reported by Werdnig (1891) and Hoffmann (1893), it is also known as Werdnig-Hoffmann disease. According to the age of onset and the degree of disease, the disease can be divided into 4 types: I-III is called child-type SMA, which belongs to autosomal recessive genetic disease, and its population incidence rate is 1/6000~1/10000, which is in infancy. The most common fatal genetic disease. SMA, which is onset from 20 to 30 years old, is classified as type IV and can be expressed in different genetic modes such as autosomal recessive, dominant and X-linked recessive. The incidence rate of the group is about 0.32/10000.

Young distal limb muscle atrophy: juvenile myoatrophy of distal upper extremity, first described by Japanese scholar Hirayama Hiroshi (1959), it is also known as Pingshan disease. The disease is a benign and self-limiting motor neuron disease, clinically similar to motor neuron disease amyotrophic lateral sclerosis, spinal progressive muscle atrophy, but the prognosis is completely different. The age of onset is young, and the affected part is mostly the distal hand muscle of the unilateral upper extremity. The EMG is neurogenic damage, and the course is benign and can be stopped by itself.

Progressive spinal muscular atrophy: The disease is a motor neuron disease, and degeneration is limited to the alpha motoneurons of the anterior horn of the spinal cord. It is characterized by muscle atrophy and muscle weakness, usually starting from the small muscles of the hand, spreading to the entire upper and lower limbs, the reflex disappears, and the sensory disorder does not appear.

Patellar muscular atrophy: Peronial myoatrophy, also known as Charcot-Marie-Tooth disease (CMT), is the most common group of peripheral neuropathy, accounting for approximately 90% of all hereditary neuropathies. The common features of this group of diseases are the onset of children or adolescents, chronic progressive sacral muscle atrophy, and the symptoms and signs are relatively symmetrical. Most patients have a family history. Because of the main clinical features of iliac muscle atrophy, it is also known as peroneal myoatrophy. According to neurophysiological and neuropathological findings, CMT is classified into type I and type II, CMTI type is called hypertrophic type, and type CMTII is called neuronal type.

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