help in diagnosis: HLAb27 positive 12 year old child

[darshan]

help in diagnosis: HLAb27 positive 12 year old child with trendelenberg positive bilaterally, from4 years difficulty in walking and back pain, weakness in gluteals, with gradual & progressiv help me in diagnosing the patient,is it ankylosing spond??

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[nmarman]

x-ray of SI joints and t/l junction will confirm this. Hla b27 is high in 90% of people with AS but is no way difinative. Was he negative for RF as well as this will help. Diagnosis a aero negative spondyloarthropathy. Is he adopted if not is there any genetic disease in family. Bilateral glut weakness can be due to pain of AS but might also be due to some other condition. I think AS is likely but it is a early presentation

[CeliaPrinsloo]

help in diagnosis: HLAb27 positive 12 year old child with trendelenberg positive bilaterally, from4 years difficulty in walking and back pain, weakness in gluteals, with gradual & progressiv help me in diagnosing the patient,is it ankylosing spond??

Did you consider something like muscle dystrophy, eg. Beckers muscular dystrophy?

[Dr Damien]

dear dashan

I am not sure it is the position of the physiotherapist to diagnose these types of medical problems. We may have our suspicions but ultimately the decision lies in the hands of a medical personnel. So please send these child to a rheumatologist/pediatrician if you can to get the appropriate tests and correct diagnosis..

many thanks

[Diilan]

dear dashan

I am not sure it is the position of the physiotherapist to diagnose these types of medical problems. We may have our suspicions but ultimately the decision lies in the hands of a medical personnel. So please send these child to a rheumatologist/pediatrician if you can to get the appropriate tests and correct diagnosis..

many thanks

This is exactly what I was thinking when I read this...this is not a situation to be fishing for a hypotheses, this young person needs to see a specialist...end of.
Apologies for being blunt

Rgds

D

[nmarman]

Yeah muscular dystrophy would be the genetic problem I was talking about. However positive hla b27 non rheumatoid marker throws a spanner in thought process. Does anybody know the relationship?? If any

[junior_physiotherapist]

Yes, I DO agree the diagnosis done by specialist not by physiotherapist as each one would help and aid in proper diagnosis and finally clear prognosis!
however may here I can say:

Becker Muscular Dystrophy:
Similar to DMD in essential characteristics:
X-linked,
Calf hypertrophy, weakness is greatest proximally, and serum CK levels are high.
EMG and muscle histology are the same.
Two differences:
Age at onset (usually after age 12)
Rate of progression (still walking after age 20, often later).