An aviator with an unusual gait: a rare disease teaches some everyday lessons

Muscular diseases including the dystrophies and myopathies are often incompatible with a variety of occupations including aviation and military duty. Many of these diseases present early in life, are readily diagnosable, and are therefore rare in the aviation community because of pre-screening and selection. Some forms, however, may not present until adulthood during an established aviation career. Furthermore, although initial presentations may be subtle and insidious, the potential occupational and aeromedical ramifications of these diseases can be profound. The following report describes the case of a subjectively asymptomatic career military aviation officer who presented with an unusual gait, and was subsequently determined to have one of the late-presenting muscle disease variants: Anterior compartment Distal Myopathy. The patient's presentation and progression, diagnostic evaluation, prognosis, aeromedical risk and disposition, and issues of occupational and aeromedical significance are discussed.