Related Experiment Video
Updated: Mar 27, 2026

Manual Muscle Testing: A Method of Measuring Extremity Muscle Strength Applied to Critically Ill Patients
Published on: April 12, 2011
Clinical Reasoning: A 67-Year-Old Man With Exercise Intolerance and Progressive Weakness
Alexi Gosset1, Sandra Perez2, Abhinav Thakral3
1Department of Neurology, University of California, San Francisco.
Abstract:
A 67-year-old man with long-standing HIV on antiretroviral therapy, type 2 diabetes with polyneuropathy, and hyperlipidemia on statin and fibrate therapy presented with difficulty walking and exercise intolerance. Examination revealed new hamstring weakness superimposed on chronic distal weakness and sensory loss. Initial laboratory testing showed elevated creatine kinase, which persisted despite discontinuation of statin and fibrate therapy. In this article, we review the approach to adult-onset myopathy and explore diagnostic challenges when clinical and diagnostic testing seem discordant, emphasizing a stepwise approach to localization, differential diagnosis, and targeted testing.
Related Concept Videos
Exercise Stress Test
Exercise stress testing, commonly known as a treadmill test, is a noninvasive procedure used to evaluate cardiovascular function and diagnose heart conditions.
Definition
An exercise stress test measures the heart's response to exertion using a treadmill or stationary bicycle. Chest electrodes record the heart's electrical activity through an ECG, and blood pressure is monitored regularly.
Purposes
Myasthenia Gravis: Diagnostic Tests
The edrophonium test is a diagnostic tool for myasthenia gravis. It involves...
Nursing Diagnosis
The nursing diagnosis focuses on evidence-based...
Peripheral Arterial Disease II: Clinical Manifestations and Diagnostic Evaluation
Exercise and Cardiac Output
Sustained exercise increases the muscles' oxygen demand, which can be...
Critical Thinking II

