Denervation pseudohypertrophy of calf muscles is a rare cause of unilateral limb swelling. It is important to exclude and consider other causes for this presentation.
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Clinical presentation
This condition usually presents as painless unilateral calf swelling.
Pathology
More commonly, denervation results in muscle atrophy but rarely it can lead to hypertrophy due to fatty infiltration/accumulation between muscle fibers 1,2.
Denervation can occur due to various causes such as trauma (e.g. peripheral nerve injury), infection (e.g. poliomyelitis), neoplasia, diabetes (i.e. diabetic peripheral neuropathy), radiculopathy, autoimmune or vasculitic causes 1-3.
Radiographic features
MRI
In acute cases, the increased signal will be noted on fluid-sensitive sequences. In chronic cases, usually after 4 weeks, increased T1 signal is noted with fatty infiltration within the musculature. This infiltration often presents as linear and featherlike intensity 1.
Differential diagnosis
infiltrating intramuscular lipoma 2
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