The nurse is providing care for a child with Duchenne muscular dystrophy. What characteristic manifestation should the nurse expect to observe?

Choice A rationale Lateral curvature of the spine, known as scoliosis, can occur in Duchenne muscular dystrophy (DMD) as a secondary complication due to progressive muscle weakness affecting the spinal support. However, it is not the primary or initial characteristic manifestation of the disease. The fundamental pathology of DMD is direct muscle fiber degeneration leading to weakness. Choice B rationale Joint inflammation is characteristic of inflammatory arthropathies, such as juvenile idiopathic arthritis. Duchenne muscular dystrophy is a primary myopathy, a disorder of muscle tissue itself, not a condition primarily involving inflammation of the joints. While secondary musculoskeletal issues can arise, joint inflammation is not a hallmark feature of the disease. Choice C rationale Duchenne muscular dystrophy is an X-linked recessive disorder characterized by the absence of dystrophin, a crucial protein for maintaining muscle fiber integrity. This leads to progressive degeneration of skeletal muscle fibers, resulting in escalating muscle weakness. This weakness typically manifests in early childhood, starting in the proximal muscles and gradually spreading, leading to loss of ambulation. Choice D rationale While severe muscle weakness in Duchenne muscular dystrophy can indirectly lead to some skeletal deformities over time, such as contractures and kyphoscoliosis, these are typically secondary consequences rather than primary manifestations. The direct and defining characteristic of the disease is the progressive degeneration and weakness of the muscles themselves.