When to Suspect DMD
There may be suspicions of Duchenne raised by one of the following signs (even when there is no family history of Duchenne):
- Development and/or speech delay
- Problems with muscle function, with the Gowers’ sign (Figure 2) being the classical sign of Duchenne
- Enlarged calf muscles (called “pseudohypertrophy”)
- Elevated CK and/or increase in transaminases, or liver enzymes AST and ALT in blood tests
Although suspicion can be raised in a variety of ways, figure 3 can help to describe the steps taken in diagnosing Duchenne.