Iliopsoas bursitis and pseudogout of the knee mimicking L2-L3 radiculopathy: case report and review of the literature.
We report the case of a 74-year-old woman who presented with acute-onset right groin pain irradiating to the thigh anteriorly after having suffered for a few weeks from slight knee pain. As a CT scan showed multiple herniated intervertebral discs and spinal stenosis at the L3-L4 level, she was referred to a neurosurgical unit with the tentative diagnosis of L2-L3 radicular pain. Investigations (MR, myelography with CT scan) showed severe acquired lumbar canal stenosis. Decompression surgery was finally postponed because of the patient's serious cardiac medical history and she was referred to us for conservative treatment. She was found to have iliopsoas bursitis with chondrocalcinosis of the knee. Local steroid injections of the two sites abolished her symptoms. We draw attention to the possible pitfalls that the radiographic appearance and one of the multiple clinical presentations of this unrare pathology may represent. Whenever a patient comes walking with crutches, avoids putting weight on his or her leg, and radicular pain is suspected, we advise consideration of other extra-spinal causes for the pain.
Al-Khodairy
A T
AT
Department of Physical Medicine and Rehabilitation, Hôpital de Gravelone, Sion, Switzerland.
Gobelet
C
C
Nançoz
R
R
De Preux
J
J
D000208:Acute Disease; D000368:Aged; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage / Q000627:therapeutic use; D002062:Bursitis / Q000175:diagnosis* / Q000188:drug therapy; D002805:Chondrocalcinosis / Q000175:diagnosis* / Q000188:drug therapy; D003937:Diagnosis, Differential; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007085:Ilium / Q000473:pathology*; D007270:Injections, Intra-Articular; D007405:Intervertebral Disc Displacement / Q000175:diagnosis; D007719:Knee Joint / Q000473:pathology*; D008159:Lumbar Vertebrae; D008279:Magnetic Resonance Imaging; D016658:Psoas Muscles / Q000473:pathology*; D011843:Radiculopathy / Q000175:diagnosis*; D013130:Spinal Stenosis / Q000175:diagnosis; D014057:Tomography, X-Ray Computed
D000894:Anti-Inflammatory Agents, Non-Steroidal