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FIG 4. MR images obtained in a 35-year-old male patient who presented with a 2-month history of left-sided sciatica due to lumbar disk herniation. MR imaging revealed a more widespread involvement of muscles of nonspecific pattern than did routine EMG (not shown).
A, Axial T1-weighted image localizes affected muscles.
B, Axial TIRM image not only shows signal intensity increase in the TA, ED, PL, P, and TP muscles (L5 radicular pattern), but also in the lateral head of the gastrocnemius (GL) muscle.
EMG studied only the medial head of the GL; no neurogenic changes were found, and the diagnosis of an L5 nerve root compression was made. CT of the lumbar spine revealed a large disk herniation compressing both the L5 and S1 nerve root (not shown) that were subsequently confirmed at surgery.
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