Neurovascular Compression Caused by Popliteus Muscle Enlargement Without Discrete Trauma

Popliteal entrapment syndrome caused by isolated popliteus muscle enlargement is very rare, although its occurrence has been reported after discrete trauma. However, popliteal artery stenosis with combined peroneal and proximal tibial neuropathy caused by popliteus muscle enlargement without preceding trauma has not been reported. A 57-year-old man presented with a tingling sensation and pain in his left calf. He had no previous history of an injury. The symptoms were similar to those of lumbosacral radiculopathy. Calf pain became worse despite treatment, and the inability to flex his toes progressed. Computed tomography angiography and magnetic resonance imaging of the lower extremity showed popliteal artery stenosis caused by popliteus muscle enlargement and surrounding edema. An electrodiagnostic study confirmed combined peroneal and proximal tibial neuropathy at the popliteal fossa. Urgent surgical decompression was performed because of the progressive neurologic deficit and increasing neuropathic pain. The calf pain disappeared immediately after surgery, and he was discharged after the neurologic functions improved.

Neurovascular Compression Caused by Popliteus Muscle Enlargement Without Discrete Trauma

Popliteal entrapment syndrome caused by isolated popliteus muscle enlargement is very rare, although its occurrence has been reported after discrete trauma. However, popliteal artery stenosis with combined peroneal and proximal tibial neuropathy caused by popliteus muscle enlargement without preceding trauma has not been reported. A 57-year-old man presented with a tingling sensation and pain in his left calf. He had no previous history of an injury. The symptoms were similar to those of lumbosacral radiculopathy. Calf pain became worse despite treatment, and the inability to flex his toes progressed. Computed tomography angiography and magnetic resonance imaging of the lower extremity showed popliteal artery stenosis caused by popliteus muscle enlargement and surrounding edema. An electrodiagnostic study confirmed combined peroneal and proximal tibial neuropathy at the popliteal fossa. Urgent surgical decompression was performed because of the progressive neurologic deficit and increasing neuropathic pain. The calf pain disappeared immediately after surgery, and he was discharged after the neurologic functions improved.

Meralgia Paresthetica Resulting from Inaccurate Wearing of a Thoraco-lumbo-sacral-orthosis / 계명의대학술지

Meralgia paresthetica is a lateral femoral cutaneous neuropathy that results in symptoms of anterolateral thigh paresthesia and numbness. Its presentation due to compression of a thoraco-lumbo-sacral-orthosis (TLSO) has not been reported. We experienced a case of a 67-year-old woman who developed left lateral femoral cutaneous neuropathy as a complication of inaccurate wearing of a TLSO. The patient suffered from tingling sensation and pain in the anterolateral aspect of the left thigh without muscular weakness. An electrodiagnostic study revealed a conduction block in the left lateral femoral cutaneous nerve (LFCN) around the inguinal ligament. Ultrasonography revealed swelling of the left LFCN compared with the right side. The patient's symptoms improved after she ceased wearing the TLSO and received conservative care. Considering the complications can develop after wearing spinal orthosis, we suggest that orthosis be prescribed accurately and inspected meticulously by experts physician.

Lower Extremity Radicular Pain Caused by Entrapped Sigmoid Colon Between L5 and S1 Vertebrae

Intestinal entrapment between two vertebral bodies is very rare. In all previous cases, it occurred by major trauma. However, the bowel entrapment between two vertebral bodies without trauma has never been reported, not to mention as the cause of lower extremity radicular pain. We describe the case of an 82-year-old female patient with right lower extremity radicular pain without recent trauma history. The patient was diagnosed sigmoid colon entrapment between the L5 and S1 vertebrae by lumbar spinal computerized tomography and magnetic resonance imaging, and showed improvement in radicular pain after manual reduction of interpositioned colon during surgery. Intestinal entrapment between two vertebrae without trauma is caused by degenerative and vacuum changes of the intervertebral disc combined with the anterior longitudinal ligament injury.