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Suggest treatment for atrophy of pectoral muscles

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Posted on Sat, 28 Mar 2015
Question: i have charcot XXXXXXX tooth disease and recently noted chest muscle atrophy. can this be due to cmt or can there be another cause
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Answered by Dr. Olsi Taka (42 minutes later)
Brief Answer:
Not likely from Charcot XXXXXXX Tooth

Detailed Answer:
I read your questions carefully and i understand your concern.

Atrophy of the pectoral muscles is not typical of charcot XXXXXXX tooth, as I suppose you yourself know it is characterized by distal muscle weakness in the limbs and doesn't typically involve your torso. There are rare cases of high severity where proximal limb girdle and thoracic muscles might be affected, but it is rare and proximal limb muscle involvement must be prominently present as well first.

There are other neurological conditions, mainly muscular dystrophies which can present with pectoral muscle atrophy like facioscapulohumeral dystrophy, Emery Dreifuss muscular dystrophy etc. However usually they manifest at an earlier age and involve other muscle groups apart from the pectoral ones. Also having one inherited neuromuscular disease is already not common, to have two of them...well I don't think there's much of a chance. Actually half an hour ago I would have said it was impossible, but after reading your question I did a bit of research and found a couple of cases with facioscapulohumeral dystrophy and CMT. So it is possible but would be an exceptional finding which would earn you a place in a neurological journal.

Another possibility would be pectoralis nerve atrophy which would have to be bilateral in your case, due to compression of the pectoralis nerve. But bilateral cases are rare, usually unilateral due to trauma, bilateral cases have been noted in people who do weight lifting I don't suppose that is your case.

Other causes may be due to systemic conditions like malnutrition, endocrine abnormalities, but these should affect other muscles as well.

Anyway these are all assumptions. In neuromuscular field physical examination is the most important component to check for the muscles involved, so I suggest you see your neurologist for a full neurological exam.

I remain at your disposal for further questions.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Olsi Taka (14 minutes later)
I do weight lifting and pushups and looking at myself there appears to be generalized atrophy of the whole chest region with my ribs apparent. I do not know if this is of any help
doctor
Answered by Dr. Olsi Taka (15 minutes later)
Brief Answer:
Read below.

Detailed Answer:
By other regions I meant mostly involvement of muscles in the shoulder girdle, facial area.
But now that you say that you do weight lifting and push ups I wonder whether there is really any atrophy, because atrophy accompanies muscle weakness, so if atrophy was really an issue you shouldn't be able to still do those exercises.

Have a look if you have earlier pictures of yours at the beach or somewhere else with a nude torso to compare whether it was the same before, might be just your normal build and you are noting it only now.

Also if you can make a photo of your torso and upload it I would gladly look at it.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Olsi Taka (1 hour later)
how do i upload picture
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Answered by Dr. Olsi Taka (49 minutes later)
Brief Answer:
Read below.

Detailed Answer:
Now I've never been at the other end, I only receive pictures, but I believe at some part in your user interface there should be an option saying "have reports" or "upload report/image" which you can click to upload the picture.

If you can't find that, another option might be to use an external site like imgur.com (there are many it's just one that I use), you upload the pic there and it will give you a link which you can give to me.

But hopefully that won't be necessary, you should be able to upload it by finding the upload report option I suggested first on this site.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Olsi Taka (2 days later)
Hi, I have provided some attachments. Please review them.
doctor
Answered by Dr. Olsi Taka (11 hours later)
Brief Answer:
Not due to CMT (charcot XXXXXXX tooth)

Detailed Answer:
If I were to judge only by those images I wouldn't say there is any marked atrophy considering your age honestly. Could it be perhaps that you have lost weight, perhaps that might give an impression of chest atrophy.
It certainly doesn't seem to have any relation with CMT as judging by the appearance of the muscles in your upper limbs your CMT is limited to the typical distal involvement, does seem to be a severe case to involve the proximal part of your limbs and your thoracic muscles.
I don't think there is a neuromuscular condition affecting your chest muscles. If you strongly feel that there is a marked change compared to the past, then a neurological exam can be performed to check for more subtle signs, but as I said before I would find a second additional condition very unlikely.

I hope to have been of help.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Dr. Olsi Taka

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Suggest treatment for atrophy of pectoral muscles

Brief Answer: Not likely from Charcot XXXXXXX Tooth Detailed Answer: I read your questions carefully and i understand your concern. Atrophy of the pectoral muscles is not typical of charcot XXXXXXX tooth, as I suppose you yourself know it is characterized by distal muscle weakness in the limbs and doesn't typically involve your torso. There are rare cases of high severity where proximal limb girdle and thoracic muscles might be affected, but it is rare and proximal limb muscle involvement must be prominently present as well first. There are other neurological conditions, mainly muscular dystrophies which can present with pectoral muscle atrophy like facioscapulohumeral dystrophy, Emery Dreifuss muscular dystrophy etc. However usually they manifest at an earlier age and involve other muscle groups apart from the pectoral ones. Also having one inherited neuromuscular disease is already not common, to have two of them...well I don't think there's much of a chance. Actually half an hour ago I would have said it was impossible, but after reading your question I did a bit of research and found a couple of cases with facioscapulohumeral dystrophy and CMT. So it is possible but would be an exceptional finding which would earn you a place in a neurological journal. Another possibility would be pectoralis nerve atrophy which would have to be bilateral in your case, due to compression of the pectoralis nerve. But bilateral cases are rare, usually unilateral due to trauma, bilateral cases have been noted in people who do weight lifting I don't suppose that is your case. Other causes may be due to systemic conditions like malnutrition, endocrine abnormalities, but these should affect other muscles as well. Anyway these are all assumptions. In neuromuscular field physical examination is the most important component to check for the muscles involved, so I suggest you see your neurologist for a full neurological exam. I remain at your disposal for further questions.