Which muscular dystrophy is associated with facial weakness and winged scapula?

• A. Emery-Dreifuss MD
• B. Facioscapulohumeral MD
• C. Duchenne MD
• D. Myotonic Dystrophy

Answer: (B)

Facioscapulohumeral muscular dystrophy is defined by weakness of the facial muscles together with weakness in the shoulder girdle, which often produces a noticeable winging of the scapula when the arms are raised. The winged scapula results from weakness of the scapular stabilizers, especially the serratus anterior and trapezius muscles, allowing the shoulder blade to protrude posteriorly. This combination of facial weakness and prominent scapulohumeral weakness with scapular winging is distinctive for this dystrophy. Other muscular dystrophies may have facial weakness or proximal arm weakness, but they don’t typically present with the same pronounced scapular winging pattern seen in facioscapulohumeral MD.