Fig. 4

Representative T1-weighted images (A–C, E–G, I–K, M–O) and fat-suppressed T2-weighted MRI images (D, H, L, P) of LGMD-R1-calpain3-related, dysferlinopathy, LGMD-R7-telethonin-related, and LGMD-R9-FKRP-related (A–D). Muscle MRI of LGMD-R1-calpain3-related revealed severe involvement of the AM and posterior compartment muscles (including the SM, ST and BF at the thigh level and the GC and SO at the calf level), GR hypertrophy and a normal appearance of the RF, QF and S at the thigh level and of the TA, TP and EDL at the calf level. E–H Muscle MRI of a patient with dysferlinopathy indicated that the posterior and anterior compartments of the thigh muscles were equally involved and that fatty infiltration of the GC, SO and PL was severe. Compared with LGMD-R1-calpain3-related, the posterior compartment of the thigh muscles was less affected, but edema of the QF and ST was predominantly observed in dysferlinopathy. I–L LGMD-R7-telethonin-related, showed severe involvement of the GMa, hamstrings, BL and AM, but the QF was relatively preserved; marked and asymmetric edema was present in the GC, SO and TA. M–P In LGMD-R9-FKRP-related, the anterior and posterior muscles in the thigh were involved; however, the S, GR and RF were relatively preserved. At the calf level, the involvement of the PL and EDL was more severe than that of the GC and SO, whereas the TA was relatively spared. Edema of the lower legs showed the opposite pattern, in which the TA, GC, SO, TP and FDL were involved, but the PL and EDL were unaffected. AM: adductor magnus; BF: biceps femoris; EDL: extensor digitorum longus; FDL: flexor digitorum longus; GC: gastrocnemius; GMa: gluteus maximus; GR: gracilis; PL: peroneus longus; RF: rectus femoris; QF: quadriceps femoris; S: sartorius; SO: soleus; ST: semitendinosus; SM: semimembranosus; TA: tibialis anterior; TP: tibialis posterior)