Discovering neurological signs: poly hill sign in FSHD patients

The sign, which was termed the “poly-hill sign” was considered positive when certain features were present. Over the superolateral border of neck, shoulder, and arm, from medial to lateral side, the following

were noted: 

(1) depression due to wasting of trapezius,

(2) a bulge due to jutting of the superior angle of the scapula, 

(3) second depression from the wasted trapezius,

(4) a bulge due to unusual bony prominence of the inferolaterally displaced acromio-clavicular joint,

(5) a depression due to wasting of the proximal one-fourth of the deltoid muscle fibers originating from the acromion processes,

(6) a bulge due to a slightly enlarged (in early stage) or relatively preserved (in late stage) distal threefourths of the deltoid muscle, 

(7) a depression due to wasted biceps muscle

(8) a bulge due to preserved bulk or hypertrophy of brachioradialis or extensor digitorum communis muscle.