Pediatrics : the hygienic and medical treatment of children . themuscles of the calves increase in size and become hard and firm. Thedeltoid, supra-, and infra-spinati muscles are similarly affected. Thethighs are rarely hypertrophied. Atrophy of the thighs and of thedeep muscles of the back and shoulder sets in. The atrophy of theserratus magnus gives the characteristic angel-wing in the disease the atrophic process becomes general, affectingeven the hypertrophied calves. The muscles of the face are notinvolved until the very last stages. Muscular Dystrophies 397 Children who ar
Pediatrics : the hygienic and medical treatment of children . themuscles of the calves increase in size and become hard and firm. Thedeltoid, supra-, and infra-spinati muscles are similarly affected. Thethighs are rarely hypertrophied. Atrophy of the thighs and of thedeep muscles of the back and shoulder sets in. The atrophy of theserratus magnus gives the characteristic angel-wing in the disease the atrophic process becomes general, affectingeven the hypertrophied calves. The muscles of the face are notinvolved until the very last stages. Muscular Dystrophies 397 Children who are affected with this form of dystrophy learn towalk late, and assist themselves by leaning on the furniture or otherobjects in their path. When the child is placed on the floor on itsback it has difficulty in getting up. It has to turn over on its facefirst, and then to aid the weakened muscles of the legs and trunk bymeans of the hands and arms, chmbing up, as it were, upon itself byplacing the hands upon the knees and then farther and farther up Fig. 260. Pseudo-hypertrophic muscular paralysis, showing enlarged calves the thighs. Fibrillary contractions do not occur. The knee-jerks insome cases disappear as the disease advances. Sensation, as a rule, isnormal. There is seldom any disturbance of the bladder or rectum. In the later stages of the disease contractions of the muscles occur,and in this way permanent distortions of the joints may result. Themost common deformities are talipes equinus and flexion of theknees and hips. Lateral curvature may occur, or a permanent flexion of the spinefrom weakness of the erector spinae muscles may result, so that the 398 Diseases oe the Bokes, Joints and Muscles child sits bowed forward, or when kneeling on the hands and feetthere is a saddle-shaped depression of the back. The electricalreactions show only quantitative changes. The reaction of degenera-tion is never present. Atrophic Fobm.—This form is known as the Landouzy-Dej^rinety
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Keywords: ., bookcentury1900, bookdecade1910, booksubjectpediatr, bookyear1917
