Proximal Leg Weakness

Proximal leg weakness is a common presentation in neuromuscular clinics. Hips flexion, abduction, adduction, and rotation are mainly achieved by iliopsoas, glutei, and obturator muscles. Hip pathology, especially when painless, may lead to diagnostic confusion that needs a good EMG of these muscles to be cleared. Most myopathies present with painless proximal leg weakness (difficulty climbing stairs and arising out of a deep chair). CIDP, diabetic amyotrophy, motor neuron diseases, and lumbar plexitis may all present similarly. Severe pain is typical of plexus pathology and is rarein myopathies. Students should be taught to avoid the assumption that proximal weakness is only caused by myopathies.