Leg Pain May Reveal Vertebral Osteoporosis: Figure 1.

Abstract

We report a case of neurological complication related to an osteoporotic vertebral fracture. A 79-year-old woman presented with a 2-month history of worsening radicular pain in her left lower limb. She had no history of trauma, and the pain was most severe in her left buttock, extending along the left posterior thigh and anterior leg. She experienced permanent radicular pain and dysethesia (pins and needles) in the L5 dermatome of the left leg in the standing position, but almost no pain while supine. Her radicular pain had been recently aggravated over a 10-day period before she presented at hospital. When she stood up or walked, the radicular pain became severe, making it impossible to walk continuously for more than 10 to 15 minutes. Questioned on past events that might be related to the compression vertebral fracture, she remembered having experienced one single episode of acute and intense low back pain during a coughing spell related to a viral bronchitis. This episode had occurred 2 weeks preceding the onset of the radicular pain. Neurologic examination revealed moderate hypoesthesia in the L5 dermatome. Deep tendon reflexes were normal. Examination also revealed mild bilateral low back pain. Her height was 160 cm and weight 57 kg; she took no regular medications and was otherwise fit and well. An osteoporotic compression fracture of the L5 vertebral body was visible … Address correspondence to Dr. Sailhan; E-mail: fred.sailhan{at}wanadoo.fr