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    1. From the age of 30 years, the proposita (case III.4 in Fig. 1 a) showed a prevalently distal muscle phenotype characterized by stepping gait with progressive pes cavus, mild proximal muscle weakness in the lower limbs, and scoliosis.

      Case III.4: Female, age 30

      DiseaseAssertion: Distal myopathy

      FamilyInfo: Figure 1, similar distal muscle weakness in four relatives. Patients I.2 and II.2 experienced foot drop while walking. Patient III.2 muscle biopsy findings suggestive of core myopathy suggested a disorder similar to his youngest sister. Patient IV.1 displayed a less progressive muscular phenotype than her older relatives and tested negative for the mutation in RYR1

      CasePresentingHPOs: HP:0001761, HP:0008994, HP:0002650

      "Pes cavus, Proximal muscle weakness in lower limbs, Scoliosis"

      CaseHPOFreeText: stepping gait

      CasePreviousTesting: muscle biopsy showed fiber size variability, increased internal nuclei and histochemical evidence of eccentric core-like lesions, Analysis of RYR1 revealed a heterozygous c.880G > A:p.(Glu294Lys) mutation

      GenotypingMethod: Amplicon-based Sanger sequencing, MotorPlex used to analyze a large set of genes that cause known forms of non-syndromic muscle disorders

      MultipleGeneVariants:

      (1) MHY7Variant: Novel

      Variant: NM_000257.4:c.4303T>C

      ClinVar: not found

      CAID: CA389040164

      gnomAD: not found

      (2) RYR1Variant:

      Variant: NM_000540.2:c.880G>A

      ClinVar: 590621

      CAID: CA072725

      gnomAD: https://gnomad.broadinstitute.org/variant/19-38939074-G-A?dataset=gnomad_r2_1

      Total allele frequency: 0.00006159 European (non-Finnish)