Occult radiological effects of lipomatosis of the lumbosacral plexus

Mark A. Mahan, B. Matthew Howe, Kimberly K. Amrami, Robert J. Spinner

Research output: Contribution to journalArticle

8 Scopus citations

Abstract

Objective: Lipomatosis of nerve (LN) is a condition of massive peripheral nerve enlargement frequently associated with hypertrophy within the distribution of the nerve, and most commonly affecting the distal limbs. We sought to understand if LN of the lumbosacral plexus would be associated with the trophic effects of LN on surrounding tissue within the pelvis, which may be clinically occult, but present on MRI. Materials and Methods: Fifty-one cases of LN, confirmed by pathology or pathognomonic appearance on MRI, were reviewed. Patients with LN of the sciatic nerve were investigated for radiological signs suggestive of overgrowth. Results Five patients had involvement of the sciatic nerve, 4 of whom had MR imaging of the pelvis. Three patients had LN involving the lumbosacral plexus, and one patient had isolated involvement of the sciatic nerve. All patients with involvement of the lumbosacral plexus demonstrated previously unrecognized evidence of nerve territory overgrowth in the pelvis, including: LN, profound adipose proliferation, muscle atrophy and fatty infiltration, and bone hypertrophy and ankylosis. The patient with LN involving the intrapelvic sciatic nerve, but not the lumbosacral plexus did not demonstrate any radiological evidence of pelvic overgrowth. Conclusion: LN is broader in anatomical reach than previously understood. Proximal plexal innervation may be involved, with a consequent effect on axial skeleton and intrapelvic structures.

Original languageEnglish (US)
Pages (from-to)963-968
Number of pages6
JournalSkeletal Radiology
Volume43
Issue number7
DOIs
StatePublished - Jul 2014

Keywords

  • Fatty infiltration
  • Lipomatosis
  • Lipomatosis of nerve
  • Macrodactyly
  • Macrodystrophia lipomatosa
  • Osteochondroma

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

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    Mahan, M. A., Howe, B. M., Amrami, K. K., & Spinner, R. J. (2014). Occult radiological effects of lipomatosis of the lumbosacral plexus. Skeletal Radiology, 43(7), 963-968. https://doi.org/10.1007/s00256-014-1871-0