Unilateral calf hypertrophy and radiculopathy: an unusual association.

A 46-year-old man presented with a 3-year history of progressive enlargement of the right calf. The patient denied local pain, weakness or paraesthesia of lower limbs. Physical examination confirmed calf enlargement with no neurological deficits (figure 1). Laboratory tests revealed mild elevation of creatine kinase (554 U/L). MRI showed an increased volume of the muscles of the posterior compartment, with signs consistent with local myositis (figure 2). Electromyogram revealed findings of S1 radiculopathy. A muscle biopsy was performed which confirmed a denervation process and revealed a discreet focal myositis process …