Which symptom is among the early signs of DMD?

• A. Frequent falls
• B. Calf pseudohypertrophy only
• C. Gower's sign only
• D. Cardiac symptoms first

Answer: (A)

Early signs of Duchenne muscular dystrophy reflect weakness of the proximal leg and hip muscles. When those muscles are first to be affected, a child has trouble with stairs, getting up from the floor, and balance, leading to frequent falls. This is why frequent falls is the best answer: it signals the initial muscle group that's failing.

Calf pseudohypertrophy tends to develop later as muscle tissue is progressively replaced by fat and connective tissue, so it isn’t typically an early sign. Gowers' sign—the need to use hands to push up from the floor—also indicates proximal weakness and can appear around the same time, but it isn’t as consistently an early sole indicator as frequent falls. Cardiac symptoms usually come later in the disease course, not at onset.