Hypertrophy of the calf with S-1 radiculopathy

Occasionally, chronic denervation is associated with enlargement rather than atrophy of muscle tissue. We studied seven patients with S-1 radiculopathy who developed ipsilateral enlargement of the calf. On the basis of results of calf muscle biopsies, it seems likely that the enlargement was due to muscle fiber hypertrophy and atrophy combined with an increase in connective tissue. Computed tomograms of the legs revealed no evidence of tumor. Surgical decompression of the involved S-1 nerve root had no obviously beneficial effect in reducing the calf enlargement. More information is needed to define the natural course of the calf enlargement and to clarify the pathophysiologic processes involved.