Which of the following are early signs of Duchenne MD?

• A. Gower's sign
• B. Calf pseudohypertrophy
• C. Frequent falls, delayed motor skills, difficulty running/jumping
• D. Late onset of symptoms

Answer: (C)

Duchenne muscular dystrophy starts with weakness in proximal muscles, especially around the hips and thighs, in early childhood. The most telling early signs are how this weakness affects movement: kids often fall more, take longer to reach motor milestones, and have trouble running or jumping because those activities rely on strong proximal leg muscles. This combination reflects the initial functional impact of the disease.

Calf pseudohypertrophy happens as the disease progresses and muscle tissue is replaced by fat and fibrous tissue, so it’s more of a later clue rather than an early one. Gower’s sign indicates proximal weakness as it becomes more apparent, but it often appears after the initial motor delays and running difficulties. Late onset of symptoms doesn’t fit Duchenne, since the condition typically presents in the preschool years.