Misdiagnosis of lumbar-sacral radiculopathy: usefulness of combination of EMG and ultrasound.
In the presence of sensitive symptoms along the lumbar-sacral dermatomeric region, it is easy to suspect a lumbar-sacral radiculopathy, it being a very common disease. Clinical evaluation, neurophysiology and magnetic resonance imaging are common tools in diagnosing lumbosacral radiculopathy. Nevertheless, sometimes tumour may mimic radiculopathy. With the improvement of ultrasound, most peripheral nerves may be virtually identified. We describe two patients where tumour of sural nerve and tibial nerve mimicked S1 radiculopathy. We diagnosed the tumours only through a comprehensive nerve assessment combining clinical evaluation, US and neurophysiology. The association of neurophysiological and imaging US assessments, possibly in the same session, may avoid misdiagnosis.
Padua
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L
Institute of Neurology, Università Cattolica del Sacro Cuore, Largo F. Vito 1, I-00168, Rome, Italy. lpadua@rm.unicatt.it
Commodari
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I
Zappia
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Pazzaglia
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C
Tonali
P A
PA
D000328:Adult; D001416:Back Pain / Q000209:etiology; D003937:Diagnosis, Differential; D003951:Diagnostic Errors; D004576:Electromyography; D006801:Humans; D008161:Lumbosacral Region; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009431:Neural Conduction; D009442:Neurilemmoma / Q000175:diagnosis* / Q000601:surgery; D010524:Peripheral Nervous System Neoplasms / Q000175:diagnosis* / Q000601:surgery; D011843:Radiculopathy / Q000175:diagnosis; D012584:Sciatic Nerve / Q000000981:diagnostic imaging / Q000473:pathology; D013497:Sural Nerve / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D014463:Ultrasonography