Unilateral Pseudohypertrophy of Calf Muscles as a Clinical Manifestation of Lumbosacral Radiculopathy

Abstract

Radiculopathy commonly presents as pain in dermatomal distribution of involved nerve roots. It is often accompanied by sensory deficit such as paresthesia, hypesthesia, and/or weakness. Neurogenic muscular atrophy is also frequent. However, hypertrophic changes may develop because of denervation in rare cases [1]. Some cases of muscle hypertrophy have been reported for neurogenic causes such as lumbosacral radiculopathy [2-4]. This unusual clinical manifestation most frequently occurs in the calf Chronic lumbosacral radiculopathy usually presents with neurogenic muscular atrophy. Hypertrophic changes in accordance with neuropathy are rare. This case report introduces a case of unilateral pseudohypertrophy of calf muscle as a clinical manifestation of chronic lumbosacral radiculopathy due to denervation. The patient presented pseudohypertrophy of muscle resulting from right L5 and S1 radiculopathy due to idiopathic spinal epidural lipomatosis (SEL). Physicians should be aware that muscle hypertrophy, which usually has been regarded as a sign of myopathy, may denote the clinical sign of radiculopathy. Electromyography can be a valuable tool for differential diagnosis in such cases.