FSHD key signs include which finding?

• A. Cardiac involvement requiring monitoring or pacemaker
• B. Facial weakness and winged scapula
• C. Elevated CK levels
• D. Slow progression

Answer: (B)

FSHD presents with a distinctive pattern of muscle weakness: the facial muscles are affected and scapular stabilizers (the muscles around the shoulder blades) weaken, leading to winged scapulas. This combination—facial weakness plus scapulohumeral weakness—is the classic, defining sign of facioscapulohumeral muscular dystrophy and is why this option is the best answer.

Other features listed don’t fit as characteristic signs. Cardiac problems requiring a pacemaker aren’t typical for FSHD, and heart involvement is not a defining feature. CK levels can be normal or only mildly elevated in FSHD, so high CK isn’t a hallmark. The disease’s progression is variable among individuals, so “slow progression” isn’t a defining sign you would rely on for diagnosis.