title: Neurogenic muscle hypertrophy in a 12-year-old girl.
abstract: Muscular hypertrophy secondary to denervation is very rare, but well-documented phenomena in adults. This is the first report of a child with neurogenic unilateral hypertrophy due to S1 radiculopathy. A 12-year-old girl presented with left calf hypertrophy and negative history of low back pain or trauma. The serum creatinine kinase level and inflammatory markers were normal. Magnetic resonance imaging showed muscle hypertrophy of the left gastrocnemius and revealed a protruded lumbar disc at the L5-S1 level. The protruded disc abuts the S1 root on the left side. Electromyography showed mild left S1 radiculopathy. Passive stretching and work load might clarify the origin of neurogenic hypertrophy but there is still a need for further evidence. Clinical, laboratory, magnetic resonance imaging and electromyography findings showed that S1 radiculopathy could be a cause of unilateral calf swelling in youth even in the absence of a history of back or leg pain.
authors.affiliation: Department of Physical Medicine and Rehabilitation, Children's Hospital Zagreb, Medical School, University of Zagreb, Croatia. Electronic address: matijazutelija@gmail.com.
authors.forename: Matija
authors.initials: M
authors.lastname: Zutelija Fattorini
authors.affiliation: Department of Rheumatology, Children's Hospital Zagreb, Medical School, University of Zagreb, Croatia.
authors.forename: Alenka
authors.initials: A
authors.lastname: Gagro
authors.affiliation: Department of Orthopaedic Surgery, University Hospital Zagreb, Croatia.
authors.forename: Tomislav
authors.initials: T
authors.lastname: Dapic
authors.affiliation: Department of Neurology, Children's Hospital Zagreb, Medical School, University of Zagreb, Croatia.
authors.forename: Goran
authors.initials: G
authors.lastname: Krakar
authors.affiliation: Department of Radiology, Royal Belfast Hospital for Sick Children, United Kingdom.
authors.forename: Josip
authors.initials: J
authors.lastname: Marjanovic
mesh_terms: D002648:Child; D005260:Female; D006801:Humans; D006984:Hypertrophy / Q000000981:diagnostic imaging / Q000209:etiology / Q000503:physiopathology; D007405:Intervertebral Disc Displacement / Q000150:complications* / Q000175:diagnosis / Q000503:physiopathology; D007866:Leg / Q000000981:diagnostic imaging*; D008159:Lumbar Vertebrae; D008279:Magnetic Resonance Imaging; D018482:Muscle, Skeletal / Q000000981:diagnostic imaging*; D009135:Muscular Diseases / Q000000981:diagnostic imaging / Q000209:etiology* / Q000503:physiopathology; D011843:Radiculopathy / Q000150:complications* / Q000000981:diagnostic imaging / Q000503:physiopathology
keywords: Calf enlargement; Denervation hypertrophy; Disc herniation; Muscle hypertrophy; Radiculopathy