Neurogenic muscle hypertrophy as an uncommon case of the calf enlargement — a case report and literature review
Abstract
Unilateral limb edema is a common diagnostic problem. Apart from the most common pathologies, i.e. chronic
venous insufficiency and lymphedema, differential diagnosis should include unusual causes of asymmetric extremity
edema. We presented a case of 41-year-old man with suspicion of lymphedema of the left calf, who reported
to a lymphology clinic. We discuss subsequent steps of the diagnostic procedure in case of the calf edema.
In our patient, neurogenic muscle hypertrophy was found to be the cause of the calf enlargement. The diagnosis
was confirmed by results of ultrasound, magnetic resonance, computed tomography, lymphoscintigraphy and
electromyography examinations. Neurogenic muscle hypertrophy is a very rare and unusual cause of the calf
enlargement. Nevertheless, it should be taken into account in the differential diagnosis.
Keywords: lymphedemaneurogenic muscle hypertrophyradiculopathy
References
- Ely JW, Osheroff JA, Chambliss ML, et al. Approach to leg edema of unclear etiology. J Am Board Fam Med. 2006; 19(2): 148–160.
- Gasparis AP, Kim PS, Dean SM, et al. Diagnostic approach to lower limb edema. Phlebology. 2020; 35(9): 650–655.
- Gutmann L. AAEM minimonograph #46: Neurogenic muscle hypertrophy. Muscle & Nerve. 1996; 19(7): 811–818, doi: 10.1002/(sici)1097-4598(199607)19:7<811::aid-mus1>3.0.co;2-c.
- Shin HHo, Jeon YH, Jang SW, et al. Neurogenic muscle hypertrophy: a case report. Korean J Pain. 2016; 29(4): 270–273.
- Gobbelé R, Schoen SW, Schröder JM, et al. S-1 radiculopathy as a possible predisposing factor in focal myositis with unilateral hypertrophy of the calf muscles. J Neurol Sci. 1999; 170(1): 64–68.
- Zabel JP, Peutot A, Chapuis D, et al. Hypertrophie musculaire neurogène : à propos de trois cas, imagerie et revue de la littérature. Journal de Radiologie. 2005; 86(2): 133–141.
- Charlot-Lambrecht I, Brochot P, Noblet H, et al. Neurogenic muscle hypertrophy. Joint Bone Spine. 2009; 76(4): 401–403.
- Costa J, Graça P, Evangelista T, et al. Pain and calf hypertrophy associated with spontaneous repetitive discharges treated with botulinum toxin. Clin Neurophysiol. 2005; 116(12): 2847–2852.
- Merkli H, Pál E, Gáti I. Asymmetric calf hypertrophy of neurogenic origin. Pathol Oncol Res. 2006; 12(4): 254–256.
- Zutelija Fattorini M, Gagro A, Dapic T, et al. Neurogenic muscle hypertrophy in a 12-year-old girl. Brain Dev. 2017; 39(1): 89–92.
- Mattle HP, Hess CW, Ludin HP, et al. Isolated muscle hypertrophy as a sign of radicular or peripheral nerve injury. J Neurol Neurosurg Psychiatry. 1991; 54(4): 325–329.
- Gorkhaly MP, Lo YL. Segmental neurogenic muscle hypertrophy associated with radiation injury. Clin Neurol Neurosurg. 2002; 105(1): 32–34.
- Walters J. Muscle hypertrophy and pseudohypertrophy. Pract Neurol. 2017; 17(5): 369–379.
- Lunde HM, Skeie GO, Bertelsen AK, et al. Focal myositis--neurogenic phenomenon? Neuromuscul Disord. 2012; 22(4): 350–354.
- Walcott BP, Nahed BV, Redjal N, et al. Pathological mechanism of lumbar disc herniation resulting in neurogenic muscle hypertrophy. J Clin Neurosci. 2011; 18(12): 1682–1684.
- Baker SK. Isolated spinal accessory mononeuropathy associated with neurogenic muscle hypertrophy: restricted neuralgic amyotrophy or stretch-palsy? A case report. Arch Phys Med Rehabil. 2008; 89(3): 559–563.