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Unilateral muscle hypertrophy and focal myositis following S1 radiculopathy

Atypical presentation of S1 radiculopathy in a 53- year-old man is presented. Patient noticed calf swelling associated with pain. Extensive radiological diagnostic procedure and muscle and bone biopsy were performed in order to exclude the presence of tumor. Electromyography of the muscles was diagnostic for radicular lesion of S1 segment. After surgical laminectomy, calf enlargement and pain remained. This case provides further evidence that chronic radiculopathy could be responsible for development of neurogenic muscle hypertrophy and focal myositis, and that careful diagnostic evaluation is needed to exclude asymmetric presentation of systemic neuromuscular condition or tumor. This is the first case describing PET/CT finding in focal myositis associated with lumbosacral radiculopathy.

Neurogenic Calf Hypertrophy; Radiculopathy; Focal Myositis

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