title: Lumbar radiculopathy caused by foraminal stenosis in rheumatoid arthritis.
abstract: METHODS
  Case-series study.
  
  
  OBJECTIVE
  To describe the clinical presentation, characteristic findings of imaging studies, and treatment of lumbar radiculopathy caused by foraminal stenosis in rheumatoid arthritis. BACKGROUND. Lumbar lesions in rheumatoid arthritis are relatively rare, with a limited number of systemic reports.
  
  
  METHODS
  Six patients with lumbar radiculopathy caused by foraminal stenosis in rheumatoid arthritis were treated. The patients were all women with a mean age of 69 years and mean rheumatoid arthritis duration of 15 years. The medical records and imaging studies of all patients were reviewed.
  
  
  RESULTS
  The affected nerve roots were L4 in four patients and L3 in two patients. Foraminal stenosis was not demonstrated in magnetic resonance images in four of the six patients. Selective radiculography with nerve root block reproduced pain, manifested blocking effect, and demonstrated compression of the nerve root by the superior articular process of the lower vertebra in all patients. Conservative treatment was performed on one patient, and surgery was conducted for the rest of the five patients; radiculopathy was improved in all patients.
  
  
  CONCLUSIONS
  Lumbar foraminal stenosis is a characteristic pathology of rheumatoid arthritis, and should be kept in mind in the diagnosis of lumbar radiculopathy. Selective radiculography is useful in the diagnosis of affected nerve roots.
authors.affiliation: Department of Orthopaedic Surgery, Nishitaga National Hospital, Sendai, Japan. koakutsu@med.tohoku.ac.jp
authors.forename: Tomoaki
authors.initials: T
authors.lastname: Koakutsu
authors.forename: Naoki
authors.initials: N
authors.lastname: Morozumi
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Koizumi
authors.forename: Yushin
authors.initials: Y
authors.lastname: Ishii
mesh_terms: D000368:Aged; D001172:Arthritis, Rheumatoid / Q000150:complications*; D005260:Female; D006801:Humans; D008159:Lumbar Vertebrae / Q000473:pathology*; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D013118:Spinal Cord Diseases / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000209:etiology*; D013130:Spinal Stenosis / Q000150:complications*; D014057:Tomography, X-Ray Computed