A 35-year-old man presented with exercise intolerance and muscle trembling since childhood. Muscle trembling appeared during muscle contraction and disappeared during relaxation. B-mode ultrasonography showed irregular vibration of muscle bundles under contraction in both longitudinal and transverse sections of the deltoid muscle, while the subcutaneous tissue maintained a relative static state. Genetic testing revealed a pathogenic c.788T>G heterozygous variant in the MYBPC1 gene. To our knowledge, this is the first reported ultrasound image of the so-called myogenic tremor. The noninvasive dynamic visualization of muscle ultrasonography is helpful for its wider application in the differential diagnosis of neuromuscular diseases.
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