Qualitative and quantitative skeletal muscle ultrasound in late-onset acid maltase deficiency

Muscle Nerve. 2011 Sep;44(3):418-23. doi: 10.1002/mus.22088. Epub 2011 Jul 13.

Abstract

Introduction: Acid maltase deficiency (AMD, or Pompe disease) is an inherited myopathic disorder of glycogen degradation. Diagnosis is often delayed. Muscle ultrasound could improve diagnosis.

Methods: We compared skeletal muscle ultrasound images from adults with AMD (n = 10) to other myopathies (n = 81) and, in AMD, compared qualitative (Heckmatt) and quantitative (backscatter) ultrasound measurements with strength and function.

Results: Qualitative ultrasound was abnormal in at least one muscle in all AMD subjects. Ultrasound patterns specific for AMD were: normal triceps brachii despite abnormalities in elbow flexors (89% vs. 17%, P < 0.0001); focal abnormalities affecting deep more than superficial biceps brachii (40% vs. 4%, P = 0.002); and more severe involvement of vastus intermedius than rectus femoris (40 vs. 11%, P = 0.03). In AMD, both qualitative (Heckmatt) and quantitative (backscatter) ultrasound measures increased with decreasing strength and function.

Conclusions: Muscle ultrasound identifies the presence and specific patterns of AMD pathology, measures disease severity, and can help in the diagnosis of AMD.

Publication types

  • Comparative Study
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Age of Onset
  • Aged
  • Diagnosis, Differential
  • Female
  • Glycogen Storage Disease Type II / diagnostic imaging*
  • Glycogen Storage Disease Type II / epidemiology*
  • Humans
  • Male
  • Middle Aged
  • Muscle, Skeletal / diagnostic imaging*
  • Muscular Diseases / diagnostic imaging
  • Sensitivity and Specificity
  • Severity of Illness Index
  • Ultrasonography
  • Young Adult