A parent reports their 5-year-old has progressive muscle weakness and a waddling gait. Which additional sign supports concern for Duchenne muscular dystrophy?

A. The child uses their hands to alternatively to lift themselves upright from sitting position due to a weak pelvic girdle: This describes Gower’s sign, a classic finding in Duchenne muscular dystrophy. Progressive proximal muscle weakness, especially in the pelvic girdle, forces the child to “climb up” their own body to stand, reflecting significant muscle degeneration. B. Early tooth eruption and advanced speech due to overactive pelvic girdle: Duchenne muscular dystrophy is characterized by progressive muscle degeneration, not overactivity. Cognitive or speech delays may occur, but early advanced development is not typical and is unrelated to pelvic muscle function. C. Hyperextensible joints and hyperactivity due to overactive pelvic girdle: Hyperextensibility is more commonly associated with connective tissue disorders such as Ehlers-Danlos syndrome. Duchenne muscular dystrophy involves muscle weakness and pseudohypertrophy, not joint hypermobility or increased activity. D. Increased fine motor and gross motor coordination due to overactive pelvic girdle: Duchenne muscular dystrophy leads to progressive decline in both gross and fine motor abilities. Coordination worsens over time due to muscle fiber degeneration, making improved motor function inconsistent with the disease process.