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Is there ever a reason to perform a muscle MRI on one side…

Is there ever a reason...
Is there ever a reason to perform a muscle MRI on one side of the body? Reason for MRI is muscle weakness
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Answered in 1 minute by:
2/15/2018
Dr. Mark
Dr. Mark, Physician / Surgeon
Category: Medical
Satisfied Customers: 12,575
Experience: U.S. Surgeon / Neurological Surgery
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Hello-Which muscle is weak? Is this your arm or leg?
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Customer reply replied 4 months ago
Both but legs are much weaker than arms
Ok. If both your arms and legs are feeling weak, your doctors may be looking at other issues than just your muscles.There are many neurological conditions which can cause weakness, and so obtaining mri imaging of the brain and spine may be helpful.Also blood work to look for electrolyte and hormone abnormalities can be useful.Mri of a specific location can be useful if weakness is confined to that one area, but I suspect in your case there may be other issues going on.
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Another helpful test for you may be an EMG, which can look for electrical disturbances in the nerves that go to your muscles, to see if there is a nerve or a muscle issue causing weakness.Best of luck.
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Customer reply replied 4 months ago
I’ve had that work done and there are some markers and suspicious areas (lesions on the brain, some bulging discs and degeneration) and EMGs show some jitter, block, and reduced activation on submaximal effort but no mri of muscles before - only want to do it once!
Customer reply replied 4 months ago
Oh and signs of sensory motor polyneuropathy on emg and skin biopsy

OK, good you've had a lot of these tests.

Perhaps they would find more use in a muscle biopsy, rather than a muscle MRI. The MRI is not likely to give you any answers (other than saying a muscle is larger or smaller than normal). A Biopsy can look at the muscle itself, and see if there is a structural problem with the muscle fibers.

Your EMG suggests there are issues with the nerves themselves going to the muscles, so the answer is likely there.

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Customer reply replied 4 months ago
Ok, are there different types of muscle biopsies or pretty much just one?
Customer reply replied 4 months ago
Someone mentioned once to do a muscle biopsy to see if there was a problem in the mitochondria because there’s a greater population in the muscle but the neurosurgeon said the yield would be low

Just one -- they will try to target a muscle in an area of weakness. For example, if you have weakness in the legs, then a sample of the calf muscle would be taken.

The yield is probably low -- actual muscle weakness related to muscle problems is relatively rare -- but when they've looked everywhere else, it can help to give some answers.

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Customer reply replied 4 months ago
is biopsying the nerve the better choice?

Well, they can biopsy the sural nerve (in the leg) to get an idea of what kind of neuropathy is affecting this nerve.

But it too is not always high yield.

I have done several nerve and muscle biopsies at the same time -- for cases similar to yours. So you may want to discuss with your doctors to see if that would be appropriate in your case.

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Customer reply replied 4 months ago
How is motor nerve health determined?

Motor nerves can be tested with EMG and nerve conduction testing.

We generally don't biopsy these, because they would leave you with weakness.

Dr. Mark
Dr. Mark, Physician / Surgeon
Category: Medical
Satisfied Customers: 12,575
Experience: U.S. Surgeon / Neurological Surgery
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Customer reply replied 4 months ago
Thank you so much for your answers, I am much better educated now. I may circle back with you later but for now, thank you!
Customer reply replied 4 months ago
I do have a followup question: does the cause or origin of muscle weakness influence the type or types of physical therapy should be undertaken? Right now, even a physical exam (therapist moving and manipulating limbs and joints) is not only painful but exhausting

Well, certain causes of weakness (such as disuse, or injury, or neuropathy) can respond well to physical therapy.

Other causes may not respond to physical therapy (neuromuscular disorders, like ALS certainly wouldn't improve with therapy, though therapy can help to maintain whatever strength is left).

But in general - the physical therapy will be very similar to help with muscle weakness - despite the diagnosis.

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Customer reply replied 4 months ago
Thank you, ***** ***** By that it would seem important to determine if there is a sensory deficit and / or motor deficit to best design the approach to physical therapy, am I correct?

Yes - certain conditions will benefit more from specific types of therapy, and the physical therapists (who go for a lot of schooling) know how to best tailor these therapies for you.

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Customer reply replied 4 months ago
Thank you again

You're welcome.

Best of luck.

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