الفهرس 
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Abstract
Chronic obstructive pulmonary disease (COPD) is common, preventable and treatable disease that is characterized be persistent respiratory symptoms and airflow limitation.
COPD may be classified as a systemic disease having musculoskeletal and metabolic consequences.
Skeletal muscle dysfunction can affect both the limb and respiratory muscles in COPD; however, the latter is often more severely impacted. Quadriceps muscle dysfunction and decreased muscle mass as determined by the cross-sectional area of the mid-thigh have a detrimental effect on COPD mortality.
When it comes to peripheral muscle strength, ultrasound-derived measurements of rectus femoris cross-sectional area have been considered a reliable predictor of muscle strength in patients with COPD.
Aim of the study : the aim of the study was to identify the correlation between rectus femoris muscle cross sectional area and severity of airway obstruction in COPD patients using ultrasound as an effort independent and radiation-free method.
A total of 48 subjects were recruited for this study, 24 COPD patients and 24 healthy subjects as a control group .All subjects underwent full history taking, clinical examination, routine laboratory investigations including CRP as inflammatory marker, radiological evaluation including CT chest without iv contrast, spirometry, 6MWT, arterial blood gas analysis, Measurement of isometric quadriceps femoris muscle maximum voluntary contraction, Ultrasound measurement of rectus femoris muscle cross-sectional area.
Results : All COPD cases have reduced rectus femoris muscle cross-sectional area RFMCSA (802.5 ± 178.1) vs (1163 ± 41.89) in control group , reduced quadriceps femoris maximum voluntary contraction (14.03 ± 3.15) kg vs (23.38 ± 3.64) kg in control group, shorter 6MWD distance (239.4 ± 55.37) meters vs (441.3 ± 44.07) meters in control group .
We found no significant correlation between FEV1 and RFMcsa in neither cases nor control groups,there was no significant correlation between FEV1 and QMVC and no significant correlation between FEV1 and mMRC dyspnea scale. However there was a very strong positive correlation between RFCSA and QMVC (r =0.881, p<0.001).
There was a statistically significant strong negative correlation between rectus femoris cross sectional area (RFCSA) and mMRC in COPD cases
(r = -0.864, p<0.001).