Hypertrophy and pseudohypertrophy of the lower leg following chronic radiculopathy and neuropathy: imaging findings in two patients

Beuckeleer, L. De; Vanhoenacker, Filip; Schepper, A. De; Seynaeve, Patrick

doi:10.1007/s002560050506

Cited by 19 publications

(7 citation statements)

References 5 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…MRI also shows linear and feather-like T1-weighted high signal intensity areas within the muscle, which is suppressed in fat-saturated sequences. The computed tomography and MRI findings correspond to the interspersion of fats in between muscle fibers [4] , [6] , [12] . There is generalized enlargement of the affected muscle, with diffuse distribution of fat and preservation of normal architecture.…”

Section: Discussionmentioning

confidence: 99%

“…The differential diagnosis of the unilateral calf enlargement includes inflammatory, infective, vascular (lymphedema, venous thrombosis, and hemorrhage), and neoplastic conditions [4] . Congenital causes of unilateral calf enlargement include hemihypertrophy syndromes, including as Klippel-Trenaunay syndrome, Proteus syndrome, macrodystrophia lipomatosa, and dystrophic muscle conditions such as Duchenne muscular dystrophy [4] . These conditions should start at a young age.…”

Section: Discussionmentioning

confidence: 99%

“… [7] described the association of denervation pseudohypertrophy of calf muscles with diabetic neuropathy. The pathophysiology of the fatty infiltration of denervation pseudohypertrophy has been reported [4] . The denervation led to a reduction in muscle fiber size, resulting in the reduction of muscular tension and relative inactivity.…”

Section: Discussionmentioning

confidence: 99%

“…On ultrasound scan, pseudohypertrophy of muscle is evident by reflective linear strands within the muscle belly [4] . Computed tomography shows an enlarged circumference of the involved limb.…”

Section: Discussionmentioning

confidence: 99%

See 3 more Smart Citations

Denervation pseudohypertrophy of calf muscles associated with diabetic neuropathy

Wong¹,

Chow²,

Lui³

et al. 2017

Radiology Case Reports

View full text Add to dashboard Cite

Denervation of muscle usually leads to muscle atrophy with fatty replacement but, uncommonly, also results in muscle hypertrophy or pseudohypertrophy with fatty replacement. We report the ultrasonographic and magnetic resonance imaging (MRI) findings of a patient with diffuse fatty infiltration of calf muscles as a result of denervation pseudohypertrophy. The elevated fasting glucose, neurogenic electromyographic changes, and muscle atrophy with adipose tissue infiltration are consistent with diabetic neuropathy as the cause of denervation pseudohypertrophy. Lumbosacral radiculopathy and plexopathy were excluded by MRI. The imaging features reported in the literature are reviewed. The important differential diagnosis of infiltrating lipoma and denervation hypertrophy, as well as other causes of monomelic hypertrophy or swelling, is discussed. This case report demonstrates the importance of MRI, with clinical, biochemical, electrophysiological, and histologic correlation in the diagnosis of denervation pseudohypertrophy. Correct diagnosis of denervation pseudohypertrophy has an important role in guiding further investigations and treatment of the disease and the underlying cause.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Denervation pseudohypertrophy of calf muscles associated with diabetic neuropathy

Wong¹,

Chow²,

Lui³

et al. 2017

Radiology Case Reports

View full text Add to dashboard Cite

show abstract

“…Thenar hypertrophy could result from either pseudohypertrophy or true hypertrophy related to spontaneous activity, increased work of remaining fibers, and fiber stretching 2, 3 . Chronic denervation and spontaneous activity on needle EMG raises the possibility of true thenar hypertrophy.…”

mentioning

confidence: 99%

An unusual cause of thenar hypertrophy and carpal tunnel syndrome

Nguyen¹,

Sen²,

Kumaravel³

et al. 2012

Muscle and Nerve

View full text Add to dashboard Cite

Muscle hypertrophy following acquired neurogenic injury: systematic review and analysis of existing literature

Strano,

Bosco,

Laurini

et al. 2024

Ann Clin Transl Neurol

View full text Add to dashboard Cite

ObjectivesNeurogenic muscle hypertrophy (NMH) is a rare condition characterized by focal muscle hypertrophy caused by chronic partial nervous injury. Given its infrequency, underlying mechanisms remain poorly understood. Inspired by two clinical cases, we conducted a systematic review to gain insights into the different aspects of NMH.MethodsWe systematically searched online databases up until May 30, 2023, for reports of muscle hypertrophy attributed to acquired neurogenic factors. We conducted an exploratory analysis to identify commonly associated features. We also report two representative clinical cases.ResultsOur search identified 63 reports, describing 93 NMH cases, to which we added our two cases. NMH predominantly affects patients with compressive radiculopathy (68.4%), negligible muscular weakness (93.3%), and a chronic increase in muscle bulk. A striking finding in most neurophysiological studies (60.0%) is profuse spontaneous discharges, often hindering the analysis of voluntary traces. Some patients exhibited features consistent with more significant muscle damage, including higher creatine phosphokinase levels, muscle pain, and inflammatory muscle infiltration. These patients are sometimes referred to in literature as “focal myositis.” Treatment encompassed corticosteroid, Botulinum Toxin A, decompressive surgery, antiepileptic medications, and nerve blocks, demonstrating varying degrees of efficacy. Botulinum Toxin A yielded the most favorable response in terms of reducing spontaneous discharges.InterpretationThis systematic review aims to provide a clear description and categorization of this uncommon presentation of an often‐overlooked neurological disorder. Though questions remain about the underlying mechanism, evidence suggests that aberrant fiber overstimulation along with increased workload that promotes focal damage may result in muscle hypertrophy. This may serve as a guide for therapeutic interventions.

show abstract

Hypertrophy and pseudohypertrophy of the lower leg following chronic radiculopathy and neuropathy: imaging findings in two patients

Cited by 19 publications

References 5 publications

Denervation pseudohypertrophy of calf muscles associated with diabetic neuropathy

Denervation pseudohypertrophy of calf muscles associated with diabetic neuropathy

An unusual cause of thenar hypertrophy and carpal tunnel syndrome

Muscle hypertrophy following acquired neurogenic injury: systematic review and analysis of existing literature

Contact Info

Product

Resources

About