Myoedema in anorexia nervosa: a useful clinical sign.

When significant weight loss occurs in anorexia nervosa, routine physical examination may reveal the striking phenomenon of myoedema or muscle mounding. This refers to the way in which a localised short-lasting swelling may be induced in a voluntary muscle as a result of tactile percussion, ideally with a patellar hammer. The present case report describes this finding in a patient with anorexia nervosa and discusses its physiological and clinical significance. It is suggested that as a clinical sign myoedema may be of value in the management of anorexia nervosa by challenging the denial of illness which is so characteristic of it. (c) 2008 John Wiley & Sons, Ltd and Eating Disorders Association.