In this issue, van Reiten et al1 demonstrate significant delays in the diagnosis of Duchenne muscular dystrophy (DMD), which may have a significant impact on clinical management. They argue that screening for DMD should be part of the routine 2-year developmental check.1 DMD is the most common and one of the most devastating disorders of skeletal muscle. Without treatment, the condition has a rapidly progressive course resulting in the loss of ambu-lation in the first decade and death in the late teens. In recent years, improvement in management has led to substantial improvements in life expectancy. From 1960 onwards, the development of specialist multi-disciplinary clinics improved mean life expectancy from 14 to 18 years. This was probably due to physical therapies for reducing contractures delaying the loss of ambulation, since the age at which ambula-tion is lost appears to correlate with long term life expectancy.
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