Muscle biopsy and interpretation

Presenter:Dr Suzeena sayyed ali

shakoor.
Moderator:Dr Amrutha
CONTENTS
-Histology of muscle
- Muscle biopsy
Histology of muscle

-Muscle tissue is responsible for movement of the body and its

parts and for changes in the size and shape of internal organs.

-There are three major types of muscle tissue: skeletal, cardiac,

and smooth muscle.

-Skeletal muscle cells called skeletal muscle fibers are very

long, cylindrical, multinucleated syncytia with diameters
from 10 to 100 micrometer. j
-Skeletal muscle fibers are held together by connective
tissue.

-Endomysium surrounds
individual fibers.

-Perimysium surrounds
a group of fibers to form a
fascicle .

-Epimysium is dense
connective tissue that
surrounds the entire muscle.
-Three types of skeletal muscle
fibers are distinguished
based on contractile speed,
enzymatic velocity, and
metabolic profile.

-The three types of fibers are

Slow fibers/ red muscles/Type 1

Fast fibers/ White muscles/ Type 2
-Type2 A
-Type2 B
-Type 2C
The structural and functional subunit of the muscle
fiber is the myofibril.

It is composed of precisely aligned myofilaments:

myosin-containing thick filaments
actin-containing thin filaments.

The smallest contractile unit of striated muscle is the

sarcomere
The light-staining isotropic I
band contains mainly thin
filaments attached to both
sides of the Z line.

The dark-staining anisotropic

A band contains mainly
thick filaments.
 MUSCLE BIOPSY

-Introduced by Duchene in 1868

-Simple but invasive procedure
-Interpretation requires detailed clinical history,physicalexamination and
laboratory tests including
-Electromyography (EMG)
-Creatine Phosphokinase (CPK) and
Relevant biochemical or serological tests.
General indications for muscle biopsy.

-Inflammatory muscle disease before giving treatment

-Proximal weakness of uncertain cause myopathy
/neurogenic
-Hereditary myopathies & muscular dystrophies
-To exclude treatable disorders eg. poliomyelitis
-Suspected metabolic myopathies
(muscle cramps/stiffness/tenderness)
-Autoimmune vasculitis
-Systemic disorders eg. sarcoidosis
-To assess the effect of steroid treatment
 Technical consideration

-Rheumatologist/Physician for inflammatory diseases,

-A neurologist for neuromuscular disease.

-Pediatrician for congenital dystrophies.