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Postgraduate Medical Journal 2002;78:182
© 2002 The Fellowship of Postgraduate Medicine


SELF ASSESSMENT QUESTION

Back pain

An uncommon cause of lumbar radiculopathy

M Belthur , R Thonse

Department of Orthopaedics, Royal Orthopaedic Hospital, Northfield, Birmingham, B31 2XP, UK

Submitted 20 June 2001
Accepted 21 August 2001


Answers on 186.

Keywords: syringomyelia; Arnold-Chiari malformation<bannerEND>Back pain

A 65 year old woman presented with a history of low back pain of 18 months' duration. There was radiation down the right lower limb posteriorly down to the ankle and the dorsum of the foot for the previous six months. Pain was aggravated by sitting and activity. Back to leg pain ratio was 40:60. There was no history of claudication pain. She did not have symptoms of weakness of legs or of bowel/bladder involvement.

She had a positive straight leg raise test on right of 50 degrees with positive sciatic stretch test. There was reduced sensation in right L5 nerve root distribution. No motor or sphincter involvement was present. The rest of the spinal examination was normal. Radiography revealed degenerative changes in the lower lumbar spine. Magnetic resonance imaging (MRI) scans (sagittal and axial views) of the patient are shown in figs 1 and 2GoGo.


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