The CK is high and on muscle biopsy there are rimmed vacuoles, focal myofibrillar destruction and autophagocytoses.[ 10 11 12 ] Welander's distal myopathy, Tibial muscular dystrophy (Udd's), Markesbery-Griggs distal myopathy, Laing's distal myopathy are all dominantly inherited late onset distal myopathies.[ 5 9 10 ] Welander's myopathy involves wrist and finger extensors where as others have anterior tibial involvement.[ 5 9 10 ] In our case two siblings were affected without clinical involvement of parents.
Source: wiktionary