Fatty Infiltration In Thigh Muscles Research Articles

Differences in fatty infiltration in thigh muscles and physical function between people with and without knee osteoarthritis and similar body mass index: a cross-sectional study

BackgroundPeople with knee osteoarthritis (OA) may have more thigh intermuscular and intramuscular adipose tissue (interMAT and intraMAT, respectively) compared to those without knee OA. Literature has not considered differences in body mass index (BMI) in the context of comparing intraMAT and interMAT between individuals with and without knee OA, matched for BMI (± 1 kg/m²). This study aims to compare interMAT and intraMAT, along with physical function (including knee extension strength), between individuals with and without knee osteoarthritis, matched by BMI.MethodsParticipants aged ≥ 40 years with symptomatic and radiological knee OA group (grade 2 and 3 on the Kellgren and Lawrence (KL) scale) were included in the affected group, while those with no knee pain and no radiological knee OA changes were included in the unaffected group. No participants were lost to assessment, ensuring complete data analysis for all participants. We used independent t-test and mean difference (95% CI) to compare thigh intraMAT and interMAT volume, self-reported measures (WOMAC questionnaire), physical function measures, and knee extension strength between groups.ResultsForty-six participants were analyzed (23 in each group). The affected group had significantly higher intraMAT compared to the unaffected group (p < 0.05), but no differences were observed for interMAT. Self-reported outcomes and physical function measures were worse in the affected group, as was knee extension strength.ConclusionPeople with knee OA present higher levels of intraMAT and poorer physical function compared to those without knee OA. These findings highlight the need for further research to explore the clinical significance of intraMAT and its potential impact on physical function in this population.

A comparative study of the fatty infiltration of thigh muscles in Becker and Duchenne muscular dystrophy

Objective To analyze the characteristics of fat infiltration into the muscles of patients with Becker and Duchenne muscular dystrophy (DMD) so as to provide a guide for rehabilitation therapy. Methods Twenty-three children with Becker muscular dystrophy (BMD) and 47 with DMD who had never been treated with glucocorticoids were enrolled. MRI was performed on both of their thigh muscles. T1 weighted images were used to assess the fat infiltration of their thigh muscles using a 0-5 modified version of Mercuri′s scale. The progression of fatty infiltration of the thigh muscles in BMD was analyzed using descriptive statistics. The differences in fat infiltration between BMD and DMD were analyzed using rank sum tests. Results In patients with BMD the adductor magnus most often showed severe fat infiltration, followed by the biceps femoris, quadriceps, semimembranosus and semitendinosus, while the sartorius, gracilis and adductor longus had the lowest percentages of severe fat infiltration. Among the BMD patients the adductor magnus, biceps femoris and quadriceps showed moderate to severe involvement at the age of 8 to 9. The semimembranosus and semitendinosus showed moderate to severe involvement at the age of 10 to 11, and the sartorius, gracilis and adductor longus showed mild to moderate involvement after 15 years of age. Among the age groups of 8, 9, 10 and 11 years old, the median total fat infiltration scores were 10, 22, 28 and 25 respectively among the BMD patients, and 29, 34, 34 and 30 respectively among the DMD patients. At age 8 significant differences between the BMD and DMD patients were observed in the infiltration scores of the adductor magnus, biceps femoris, vastus lateralis, rectus femoris, vastus medialis, vastus intermedius and in the total scores. At age 9 significant differences persisted in the scores of the adductor magnus, rectus femoris, vastus medialis, vastus intermedius and the total scores. Conclusions The muscle MRIs showed significant differences in the degree of fatty infiltration between BMD and DMD patients. These findings may be useful when designing therapeutic regimens and rehabilitation programs for patients with BMD and DMD. Key words: Muscular dystrophy; Muscles, Skeletal; Fatty infiltration

Muscle MRI in Duchenne muscular dystrophy: Evidence of a distinctive pattern

The purpose of this study was to describe the pattern of muscle involvement using MRI findings and correlate with functional as well as muscle strength measurements. Fifty genetically confirmed DMD children with a mean age of 7.6 ± 2.8 (4–15 years) underwent muscle MRI and qualitative assessment was done for muscle changes using Mercuri staging for fibro-fatty replacement on T1 sequence and Borsato score for myoedema on STIR sequence. Detailed phenotypic characterisation was done with Manual muscle testing (modified MRC grading) and Muscular Dystrophy Functional Rating Scale (MDFRS). Mercuri scoring showed severe fibro-fatty changes in Gluteus medius, minimus and Adductor magnus followed by moderate to severe changes in Gluteus maximus and Quadriceps muscles. Total sparing of Gracilis, Sartorius and Semimembranosus muscles was observed. Superficial posterior and lateral leg muscles were preferentially involved with sparing of deep posterior and anterior leg muscles. Myoedema showed significant inverse correlation with fatty infiltration in thigh muscles. Similarly, significant inverse correlation was observed between Mercuri scores and MRC grading as well as MDFRS scores. A direct linear correlation was observed between duration of illness and fibro-fatty changes in piriformis, quadriceps and superficial posterior leg muscles. There was no correlation between MRI findings and genotypic characteristics. However, this specific pattern of muscle involvement in MRI could aid in proceeding for genetic testing when clinical suspicion is high, thus reducing the need for muscle biopsy. Fibro fatty infiltration as measured by Mercuri scoring can be a useful marker for assessing the disease severity and progression.

A study on the bifurcation of sciatic nerve with clinical significance

The purpose of this study was to describe the pattern of muscle involvement using MRI findings and correlate with functional as well as muscle strength measurements. Fifty genetically confirmed DMD children with a mean age of 7.6 ± 2.8 (4–15 years) underwent muscle MRI and qualitative assessment was done for muscle changes using Mercuri staging for fibro-fatty replacement on T1 sequence and Borsato score for myoedema on STIR sequence. Detailed phenotypic characterisation was done with Manual muscle testing (modified MRC grading) and Muscular Dystrophy Functional Rating Scale (MDFRS). Mercuri scoring showed severe fibro-fatty changes in Gluteus medius, minimus and Adductor magnus followed by moderate to severe changes in Gluteus maximus and Quadriceps muscles. Total sparing of Gracilis, Sartorius and Semimembranosus muscles was observed. Superficial posterior and lateral leg muscles were preferentially involved with sparing of deep posterior and anterior leg muscles. Myoedema showed significant inverse correlation with fatty infiltration in thigh muscles. Similarly, significant inverse correlation was observed between Mercuri scores and MRC grading as well as MDFRS scores. A direct linear correlation was observed between duration of illness and fibro-fatty changes in piriformis, quadriceps and superficial posterior leg muscles. There was no correlation between MRI findings and genotypic characteristics. However, this specific pattern of muscle involvement in MRI could aid in proceeding for genetic testing when clinical suspicion is high, thus reducing the need for muscle biopsy. Fibro fatty infiltration as measured by Mercuri scoring can be a useful marker for assessing the disease severity and progression.

Study on T2 mapping in thigh muscles of patients with Duchenne muscular dystrophy

Objective Use T 2 mapping to evaluate the fatty infiltration of thigh muscles in Duchenne muscular dystrophy (DMD) patients, so as to analyze the value of T 2 mapping and T 2 relaxation time in the diagnosis of DMD. Methods Sixteen DMD patients who were admitted from January 2004 to January 2013 in our hospital and were diagnosed by clinical confirmation and gene detection have participated into this study. These 16 male patients formed the DMD group. Six age- and sex-matched healthy boys were selected as control group. Clinical functional scale, thigh axial T 1 WI-turbo spin echo (TSE), T 2 WI-TSE, spectral attenuated inversion recovery (SPAIR)-T 2 WI and T 2 mapping were performed in both 2 groups. T 1 WI fatty infiltration scale and T 2 relaxation time were assessed in adductor magnus, gracilis, adductor longus, sartorius, rectus femoris, vastus intermedius, vastus medialis, vastus lateralis, biceps femoris, semitendinosus and semimembranosus. Spearman rank correlation was conducted to assess the correlation between T 2 relaxation time and T 1 WI fatty infiltration scale or clinical functional scale. Results Compared with control group, the T 2 relaxation time of 8 muscles (adductor magnus, adductor longus, rectus femoris, vastus intermedius, vastus medialis, vastus lateralis, biceps femoris and semimembranosus) in DMD group were prolonged ( P < 0.05, for all). The longest average T 2 relaxation time was found in adductor magnus. The T 2 relaxation time of adductor magnus, vastus intermedius, vastus lateralis, biceps femoris, rectus femoris, adductor longus and vastus medialis was positively correlated with T 1 WI fatty infiltration scale ( P < 0.05, for all), and the T 2 relaxation time of adductor magnus and semimembranosus was positively correlated with clinical funetional scale ( P < 0.05, for all). A positive correlation was found in adductor magnus between T 2 relaxation time and both T1WI fatty infiltration scale ( r s = 0.867, P = 0.000) and clinical functional scale ( r s = 0.651, P = 0.005). Conclusions T 2 relaxation time could be used in the quantitative and objective analysis of DMD clinical severity, and adductor magnus was considered to be the most valuable muscle to reflect the clinical severity of DMD. DOI: 10.3969/j.issn.1672-6731.2015.06.004

THU0372 MRI quantification of fat infiltration in skeletal muscle of patients with camptocormia

BackgroundPrimitive progressive lumbar paravertebral muscle weakness commonly known as Primitive Camptocormia and also referred to as “bent spine syndrome” is characterized by an abnormal trunk posture with marked flexion of...

Specific muscle strength is reduced in female knees with incidcence radiographic osteoarthritis

s / Osteoarthritis and Cartilage 21 (2013) S63–S312 S220 415 SPECIFIC MUSCLE STRENGTH IS REDUCED IN FEMALE KNEES WITH INCIDCENCE RADIOGRAPHIC OSTEOARTHRITIS M. Sattler y, J. Niu z, T. Dannhauer y, W. Wirth y, D. Felson z, F. Eckstein y. y Paracelsus Med. Univ., Salzburg, Austria; zClin. Epidemiology Res. & Training Unit, Boston Univ. Sch. of Med., Boston, MA, USA Purpose: Quadriceps strength plays an important role in knee biomechanics. Quadriceps weakness has been shown to be related to the onset of knee symptoms in women, but has not been associated with incident radiographic knee OA (KOA). However, previous studies have not examined muscle specific strength, a potentially more physiologically relevant measure of strength that accounts for the individual cross sectional area (CSA) of muscles. Here we explore whether specific strength differs between knees with incident radiographic KOA vs. nonincident controls. Methods: Of 4796 Osteoarthritis Initiative participants, we studied knees that showed incident radiographic KOA (central readings, fixed flexion radiographs). These were defined as Kellgren and Lawrence grade (KLG) 0 or 1 knees at baseline, in which the combination of a definite osteophyte AND joint space loss (OARSI JSN>grade1) developed by 48 month follow up. These knees were matched by baseline KLG0/KLG1 frequency (w30%/70%) to control knees without incident KOA at 48M. Of 447 case and control knees, 342 had axial T1weighted spinecho MRIs of the thigh AND maximal isometric strength measures of the extensors and flexors (Good Strength Chair, Metitur). To determine CSAs of the quads, hamstrings and adductors, we selected an MRI slice located at 30% femoral length (distal to proximal) based on an estimate derived from body height. Strength was normalized to weight (norm_strength1⁄4strength/weight). Muscle quality was evaluated by computing spec_strength (the primary analysis), and by the mean and standard deviation (SD) of the T1weighted thigh muscle MRI signal intensity (as a proxy of fatty infiltration). Cases and controls were compared using conditional logistic regression. Results: Of 179 knees with incident radiographic KOA, 113 were female (age 60.8, BMI 29.2) and 66 male (60.4; 29.4); of 195 non-incident knees, 113 were female (60.8, 27.0) and 82 male (59.4; 27.7). Quad spec_strength was found significantly (-12%) lower in incident vs. nonincident knees (Table 1). Quad strength (-7.1%) and norm_strength (-15%) were also significantly lower, quad CSA significantly greater (+6.5%), and the mean and SD quad MRI signal intensity greater (w5%, not significant) in incident vs. non-incident knees (Table 1). Similar relationships were observed in the flexors and adductors. In male knees, in contrast, the observed thigh muscle spec_strength was greater in incident than in non-incident knees, but the difference did not reach statistical significance. Conclusion: In women (but not in men), incident radiographic KOA is found to be associated with lower muscle strength per unit CSA (spec_strength) and per unit weight (norm_strength). Obesity, which is independently associated with incident radiographic KOA inwomen, may be associated with fatty infiltration of thigh muscles, and may cause an unfavourable ratio between loading and muscular stabilization of the knee. Our findings suggest that important relations of muscle function and risk of radiographic KOA exist and are detected with physiologically relevant measures of strength (i.e. specific strength). Quadriceps muscle status in incident and non-incident female knees Incident Non-incident