What is a typical sign of muscular dystrophy, particularly the Duchenne type?

• A. Reduced calf size.
• B. Learning disabilities only.
• C. Extreme upper body strength.
• D. Enlarged calves (pseudohypertrophy).

Answer: (D)

Calf pseudohypertrophy is a hallmark sign of Duchenne muscular dystrophy. In this condition, muscle tissue is gradually replaced by fat and connective tissue, especially in the calves, so the legs appear enlarged even though the muscles are actually weak. This apparent enlargement is called pseudohypertrophy because it’s not real muscle growth. Children with Duchenne typically show weakness in proximal muscles—the hips and thighs—making it hard to rise from the floor or climb stairs, and they may use a Gowers’ maneuver to stand up. While some individuals may have cognitive differences, the enlarged calves are the classic, visually recognizable sign. The other options don’t fit: calf size is usually increased, not reduced; learning disabilities alone aren’t the defining sign; and extreme upper body strength is not characteristic of Duchenne, which presents with weakness rather than excess strength in the upper body.