This video demonstrates slow, wavelike muscle rippling occurring perpendicular to the long axis of the quadriceps in response to percussion by the examiner’s hand. Needle electromyography of the vastus lateralis (not shown) demonstrated electrical silence during the rippling, typical of this disorder. Rippling muscle disease is a rare neuromuscular disorder, which may be hereditary due to pathogenic variants in the or genes, or immune mediated and responsive to immunotherapy. The patient in this video has iRMD, with associated cavin-4 IgG antibodies.
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