Frequency of potential causes of lower back pain and incidental findings in patients with suspected sacroiliitis: retrospective analysis of 886 patients with negative sacroiliac MRI examination for sacroiliitis

Acta Radiologica ◽

10.1177/0284185120968565 ◽

2020 ◽

pp. 028418512096856

Author(s):

Hasan Emin Kaya ◽

Ülkü Kerimoğlu

Keyword(s):

Back Pain ◽

Lower Back Pain ◽

Incidental Findings ◽

Uterine Fibroids ◽

Mri Imaging ◽

Imaging Studies ◽

Lower Back ◽

Lumbosacral Transitional Vertebra ◽

Sacral Insufficiency Fractures ◽

Magnetic Resonance Imaging Mri

Background In a majority of patients with suspected sacroiliitis (SI) who underwent sacroiliac magnetic resonance imaging (MRI), imaging studies may be normal, may depict other causes for pain, or may show clinically irrelevant incidental findings. Purpose To determine the prevalence of possible etiologies other than SI and frequency of incidental findings demonstrated on sacroiliac MRI examinations in a cohort of patients with lower back pain and suspected SI. Material and Methods Sacroiliac MRI examinations of 1421 patients with suspected SI were retrospectively reviewed. In patients without SI findings, other potential causes for lower back pain and incidental findings were documented. Results SI was present in 535 of 1421 patients (37.6%). In 886 of the patients whose MRI studies were negative for SI, other possible causes for lower back pain or incidental findings were seen in 386 (43.5%). The most common musculoskeletal (MSK) finding was lumbosacral transitional vertebra (8.6%) followed by findings suggesting piriformis syndrome (4.2%), spondylosis (3.7%), and sacral insufficiency fractures (1.8%). The most common non-MSK findings were follicular cysts (15.3%) and uterine fibroids (4.9%). Conclusion In patients with suspected SI but negative MRI examinations for SI, some other possible causes for lower back pain and several incidental findings can be seen on imaging. The presence of these findings may explain the patient’s symptoms, and awareness of these conditions may be helpful in patient management and individualizing treatment.

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Lower back pain with sciatic disorder following L5 dermatome caused by herpes zoster infection

Orthopedic Reviews ◽

10.4081/or.2015.6046 ◽

2015 ◽

Vol 7 (3) ◽

Cited By ~ 2

Author(s):

Roslind Karolina Hackenberg ◽

Arnd Von den Driesch ◽

Dietmar Pierre König

Keyword(s):

Back Pain ◽

Herpes Zoster ◽

Lower Back Pain ◽

Pain Treatment ◽

Acute Onset ◽

Mri Scan ◽

Lower Back ◽

Acyclovir Treatment ◽

Magnetic Resonance Imaging Mri ◽

The Right

We report the case of a 62-year-old patient with lower back pain radiating into the right leg accompanied by numbness. The pain had an acute onset and was resistant to conservative pain treatment. A magnetic resonance imaging (MRI) scan of the lumbar spine showed no degenerative discovertebral lesions, but a swelling of the nerve root supplying the affected dermatome. For pain treatment the patient received lumbar epidural infiltrations. During this treatment the patient suddenly developed a skin rash with grouped vesicular blisters on an erythematous ground. After the diagnosis of a lumbar herpes zoster and an acyclovir treatment, the patient could be discharged in an ameliorated condition. This case demonstrates the importance to consider rare causes of lumbosciatic pain and disorders and to acknowledge unspecific changes in a MRI scan.

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Relief of Lower Back and Leg Pain after Myelography

The Open Orthopaedics Journal ◽

10.2174/1874325001610010539 ◽

2016 ◽

Vol 10 (1) ◽

pp. 539-542

Author(s):

Rui Guo ◽

Toshihiko Sakakibara ◽

Tetsutaro Mizuno ◽

Koji Akeda ◽

Tetsushi Kondo ◽

...

Keyword(s):

Back Pain ◽

Intermittent Claudication ◽

Lower Back Pain ◽

Adverse Reactions ◽

Leg Pain ◽

Mri Findings ◽

Spinal Disorder ◽

Lower Back ◽

Magnetic Resonance Imaging Mri ◽

Lumbar Spinal

Introduction: It is well-known that many patients will have adverse reactions such as headache and nausea after undergoing myelography, but we have often seen cases where symptoms such as lower back pain and leg pain were alleviated following myelography. To the best of our knowledge, such clinical cases of post-myelographic alleviation have not been reported. Materials and Methods: A total of 325 patients with a degenerative lumbar spinal disorder who underwent myelography were prospectively investigated at four hospitals from April 2012 to March 2014 to survey the post-myelographic alleviation of lower back and leg pain prospectively. The severities of lower back pain, leg pain and numbness of the lower extremities were evaluated and intermittent claudication distance was measured before myelography. The magnetic resonance imaging (MRI) findings and myelographic findings were also evaluated for the patients that their symptoms were improved. Results: Thirty-five of 325 cases (10.8%) of these patients had their symptoms alleviated after undergoing myelography; 26 cases of lower back pain, two cases of leg pain, two cases of numbness of the lower extremity, and five cases of intermittent claudication. Conclusion: In the patients of a degenerative lumbar spinal disorder, about 10% cases with lower back pain or intermittent claudication had post-myelographic alleviation. Intradural injection therapy might be a therapeutic method to alleviate these symptoms.

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Algorithm of Radiological Diagnostics of Dystrophic Damage to Ligaments of the Lumbosacral Spine in the Lower Back Pain Syndrome: the Potential of Sonography

Health and Ecology Issues ◽

10.51523/2708-6011.2018-15-4-21 ◽

2018 ◽

pp. 109-114

Author(s):

A. N. Mihailov ◽

A. M. Yurkovskiy ◽

I. V. Nazarenko

Keyword(s):

Back Pain ◽

Lower Back Pain ◽

Structural Changes ◽

Clinical Manifestations ◽

Diagnostic Errors ◽

Diagnostic Algorithm ◽

Pain Syndrome ◽

Lumbosacral Spine ◽

Lower Back ◽

Magnetic Resonance Imaging Mri

Objective: to formulate the main points of the diagnostic algorithm in the lower back pain syndrome caused by pathology of the ilio-lumbar, posterior long sacroiliac, and sacrotuberal ligaments based on the limits and potential of visualization methods. Material. Data of X-ray, multispiral computer tomography (MSCT), magnetic resonance imaging (MRI) and sonography of 184 patients aged 19-79 with clinical manifestations of the lower back pain syndrome caused by pathology of the ilio-lumbar, posterior long sacroiliac, and sacrotuberal ligaments were analyzed. Results. The potential of the visualization methods in the assessment of structural changes of the ilio-lumbar, posterior long sacroiliac, and sacrotuberal ligaments has been identified. The main points of the algorithm which makes it possible to diagnose the lower back pain syndrome, caused by pathology of ilio-lumbar, posterior long sacroiliac and sacrotuberal ligaments have been formulated. Conclusion. The choice of the visualization method in the lower back pain syndrome, caused by ligamentosis of the ilio-lumbar, posterior long sacroiliac, and sacrotuberal ligaments must be made taking into account the limits and potential of MSCT, MRI and sonography, which will shorten the time of diagnostic search and reduce the risk of diagnostic errors.

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JUSTIFICATION OF RADIOLOGICAL PROCEDURES ALGORITHM ADJUSTMENT IN DIAGNOSIS OF LOWER BACK PAIN CAUSE AT UNIVERSITY CLINICAL CENTER TUZLA

Acta Medica Saliniana ◽

10.5457/ams.v49i1.489 ◽

2019 ◽

Vol 49 (1) ◽

Author(s):

Aida Denjagić

Keyword(s):

Back Pain ◽

Lumbar Spine ◽

Radiation Dose ◽

Lower Back Pain ◽

Lower Back ◽

Clinical Center ◽

Spine Ct ◽

Diagnostic Key ◽

Magnetic Resonance Imaging Mri ◽

Radiological Procedures

Introduction: Lower Back Pain (LBP) is one of the most frequent reasons for visiting physican. Authors of guidelines scrutinizing use of radiography and Computed tomography (CT) or Magnetic resonance imaging (MRI) in LBP diagnostic. Method of choice in the LBP diagnostic should be MRI except in cases where we should get diagnostic informations as soon as possible (traumas etc.) and in strict indications in bone structures where CT should be a method of choice. Increase of CT use and following icrease CT derived radiation dose in patients are very serious problems of last decades. Aim: To show the nessesary of procedure algorithm adjusment in LBP diagnostic. Reasons are: danger of overdiagnosis leading to chronifications, loosing time and money to get exact diagnose and leading to cumulate very high ionizing doses (10 mSv per person with average body weight from lumbar spine CT) that could couse a cancer if it is over 100 mSv (in some studies if it is over 50 mSv). Patients and methods: Sixty-nine patients, average age of 51.35 years, were included in the study. Lumbar spine CT was performed and repeated procedure at MRI in a very short time in Clinic for Radiology and Nuclear Medicine of University Clinical Centre Tuzla from January 1 2017 to February 9 2018. The sample of patients was formed consecutively. Referral diagnosis for CT procedures were: M51 in 36 patients (52.17%), N/A in 13 (18.84%), M05 in 4 (5.8%), G83.4 in 3 (4.35%) and other in 13 (18.84%). Results: 30 (83.33%) of patients were referred from CT to MRI procedure in time under 42 days (during acute phase). Relation of justified and unjustified undertaken CT procedures were: 71% unjustified, 10% justified and 19% N/A.Conclusion: Performed study showed unjustified undertaken CT procedures and high unnecessary radiation dose in 71% patients. There are justified reasons for procedure algorithm adjusment in LBP diagnostic. Key words: lower back pain, diagnostic procedure algorithm, CT, MRI

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