Muscular dystrophy Quiz: Ace Your Exams
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A 4-year-old boy is brought to the office by his parents for evaluation of leg pain. He has been experiencing progressive leg pain over the past 3 months that is worse with activity. The parents report that the patient also has difficulty running and walking up stairs for the past year, and they have noticed that he always “walks on his toes.” He was adopted as an infant, and family history is unknown. Vitals are within normal limits. Height, weight and head circumference is at 20th percentile, similar to previous visits. Physical examination shows bilateral calf hypertrophy and thin, atrophied thighs. Extremities are nontender to palpation. When asked to rise from the floor the boy uses hand support to push himself to an upright position. He has a waddling gait. Which of the following laboratory tests will most likely help to develop a diagnosis?
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