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Case Reports
. 2013 Aug 19:2013:bcr2013200083.
doi: 10.1136/bcr-2013-200083.

Delayed postirradiation camptocormia

Linda Kelly  1 , Laura D Perju-Dumbrava, Dominic Thyagarajan, Yong Chern Lee
Affiliations
Case Reports

Delayed postirradiation camptocormia

Linda Kelly et al. BMJ Case Rep. .

Abstract

Radiotherapy may cause central or peripheral nervous system complications, reported examples being myelopathy, brachial/lumbosacral plexopathies or predominantly motor lumbosacral radiculopathy. In the literature some studies regard camptocormia as a paravertebral myopathy and others as of neurogenic origin. We present a patient who developed camptocormia, 42 years after radiation therapy to the para-aortic and inguinal area.

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Figures

Figure 1
Figure 1
(A) Forward flexion of the spine compensated by bending of the knees when standing. (B) Marked atrophy of the paraspinal muscles. (C) Normal position of the spine when lying down.
Figure 2
Figure 2
(A and B) Sagittal T2 and T1 images of the lumbar spine demonstrated increased signals throughout the lumbar vertebrae in keeping with postradiotherapy change. Mild to moderate reduction in height of L1 vertebral body (white arrow) and L5 vertebral body (black arrow) with superior end-plate involvement would be the result of old compression fractures.
Figure 3
Figure 3
(A) Axial T2 image of the lumbar spine showed marked atrophy of paraspinal muscles (black arrow) bilaterally with increased T2 signals in keeping with fatty replacement. There was also moderate atrophy of psoas (white arrow head) and quadratus lumborum (black arrow head) on both sides. (B) Axial T2 image of the same patient performed 6 months after the initial MRI confirmed persistent fatty atrophy of the paraspinal muscles (black arrow) bilaterally. There was a further very mild increase of atrophy of quadratus lumborum (black arrow head) on both sides. Both psoas (white arrow) did not show any significant change.
Figure 4
Figure 4
Coronal T1 image showed marked atrophy of paraspinal muscles (black arrow) bilaterally with increased T1 signal in keeping with fatty replacement.
See this image and copyright information in PMC

References

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Supplementary concepts