PMC5577086_01
MRI of the lower extremities. (A) T1-weighted image of femoral muscles shows muscle atrophy of the left sartorius, biceps femoris, semimembranosus, and semitendinosus (arrowheads). (B) Fat suppression image of femoral muscles shows hyperintense signals in the left biceps femoris muscle (arrowhead). (C) T1-weighted image of the calf muscles shows no muscle atrophy. (D) Fat suppression image shows diffuse hyperintense signals in both the anterior and posterior compartments of the left lower leg muscles.
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Fat suppression MRI revealed mild muscle atrophy of the left sartorius, biceps femoris, semimembranosus, and semitendinosus accompanied by slightly hyperintense signals (Fig. 1A and B), and diffuse hyperintense signals in both the anterior and posterior compartments of the left lower leg muscles (Fig. 1C and D).
Histopathological findings of the left tibialis anterior muscle. (A) Hematoxylin and Eosin staining section shows marked variations in the fiber size and focal mild inflammatory cell infiltration (arrow). (B) Necrotic fibers (arrows) and pyknotic nuclear clumps (arrowhead). (C) ALP stained section shows regenerated fibers (arrows). (D) ATPase (pH 4.6) stained section shows type 1 fiber-dominant atrophy with mild fiber type grouping. The bars in all panels indicate 100 microm.
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A histopathological analysis revealed a marked variations in the fiber size and mild inflammatory cell infiltration, scattered necrotic and regenerated muscle fibers, and pyknotic nuclear clumps (Fig. 2A, (B and (C). Type 1 fiber-dominant atrophy with mild fiber type grouping was observed (Fig. 2D).