Extraspinal causes of sciatica. A case report.
METHODS
A case of intrapelvic aneurysm is reported. It is as an example of one of the many extraspinal causes of sciatica.


OBJECTIVE
To demonstrate the importance of clinical examination in the assessment of patients with sciatic, despite continuing improvements in methods for imaging the spine.


BACKGROUND
Extraspinal conditions cause sciatic in a rare but recognized group of patients. Their clinical symptoms can be very similar to those of patients with sciatic from lumbar disc protrusion.


METHODS
The clinical appearance, investigation, and treatment of a patient with an internal iliac artery aneurysm causing sciatic are discussed.


RESULTS
Surgical treatment of the patient's aneurysm resulted in relief of the symptoms of sciatica.


CONCLUSIONS
Although these cases are unusual in isolation, together they represent an important group. When a patient has sciatica, the clinician looks first to the spine for the origin of symptoms. Extraspinal causes are often not considered in the differential diagnosis. This oversight may be compounded by observation of asymptomatic disc protrusions on computed tomographic and magnetic resonance studies. The importance of clinical history and examination in the diagnosis of these lesions cannot be overemphasized.
Dudeney
S
S
Department of Orthopedic Surgery, Beaumont Hospital, Dublin, Ireland.
O'Farrell
D
D
Bouchier-Hayes
D
D
Byrne
J
J
D000783:Aneurysm / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D010388:Pelvis / Q000098:blood supply*; D010808:Physical Examination; D012585:Sciatica / Q000209:etiology*; D014057:Tomography, X-Ray Computed