Before performing tests, the doctor will begin by taking the patient's medical history and physical examination. If the doctor suspects that MD is the cause of the patient's symptoms, he or she will perform a series of tests that may include: Enzyme tests, which test the blood for enzymes called creatine kinase (CK), these enzymes are present in the blood only if of muscle damage has occurred. Elevated CK levels may suggest muscle disease; Electromyography is used by inserting an electrode needle into the affected muscle. Electrical activity is then measured as the patient slowly flexes and extends the muscle. Changes in the pattern of electrical activity can confirm muscle disease; Genetic testing is used to check for mutations in the blood, this type of test is mainly used to identify the type of MD affecting the patient; Muscle biopsy is another test used by doctors to determine a patient's type of MD. This is done by surgically removing a small piece of the affected muscle and performing tests; Heart and lung monitoring tests observe the changes that MD has on the heart and lungs during later stages. This test is also used to assist doctors in diagnosing type 1 CMD