Optional medical device diagnostics – depending on the results of the history, physical examination, and obligatory laboratory parameters – for differential diagnostic clarification.
- Electromyography (EMG; measurement of electrical muscle activity) – if there is evidence of myotonic disease (inflammatory or degenerative myopathy or even neurogenic damage).
- X-rays of spine, ribs or other joints/bones – if bony cause is suspected.
- Sonography (ultrasound examination) of the muscle.
- Angiography (imaging of blood vessels by contrast medium in an X-ray examination) – for suspected peripheral vascular disease, unspecified.
- Computed tomography of the skull (cranial CT, cranial CT or cCT) – if neurological problems such as Parkinson’s disease or Guillain-Barré syndrome (GBS) are suspected.
- Computed tomography (CT; sectional imaging method (X-ray images from different directions with computer-based evaluation)) of the spine (spinal CT) – in suspected neurological problems such as Parkinson’s disease or Guillain-Barré syndrome.
- Magnetic resonance imaging of the skull (cranial MRI, cranial MRI or cMRI): computer-assisted cross-sectional imaging (using magnetic fields, that is, without X-rays) – in suspected neurological problems such as Parkinson’s disease or Guillain-Barré syndrome.
- Magnetic resonance imaging (MRI) of the spine (spinal MRI): particularly well suited for imaging soft tissue injuries – in:
- Method of choice for the evaluation of skeletal pathologies.
- Suspected neurologic problems such as Parkinson’s disease or Guillain-Barré syndrome.
- Magnetic resonance imaging (MRI) of the extremities (extremity MRI) – for intrinsic muscle injuries[Classification of intrinsic muscle injuries by MRI scan according to the Munich consensus:
- Grade 0 injury: edema (swelling) with possible muscle fiber injury <5 mm (functional damage).
- Grade-1 injury: smallest muscle fiber injuries < 10 mm: Overstretching, strain; promise of only a few muscle fibers; mild signs of inflammation, swelling; strain-dependent stretching pain.
- Grade 2 injury: significant muscle defect > 10 mm: Partial rupture (tearing tissue), muscle fiber tear with cutting pain; significantly limited strength and mobility (possibly palpable tissue gap).
- Grade 3 injury: complete tear of the muscle, possibly with retraction: tear or tear with complete loss of function; palpable, possibly visible muscle cell; hematoma discoloration due to hemorrhage.
- Thyroid ultrasonography (ultrasound examination of the thyroid gland) – if hypothyroidism is suspected.
