ABSTRACT
Orthopaedic surgeons frequently treat patients who report pain that radiates from the back into the lower extremity. Although the most common etiology is either a herniated disk or spinal stenosis, a myriad of pathologies can mimic the symptoms of radiculopathy, resulting in differences in the clinical presentation and the workup. Therefore, the clinician must be able to distinguish the signs and symptoms of lumbar radiculopathy from pathologies that may have a similar presentation. Being cognizant of these other possible conditions enables the physician to consider a breadth of alternative diagnoses when a patient presents with radiating lower extremity pain.
Subject(s)
Radiculopathy/diagnosis , Radiculopathy/etiology , Diabetic Neuropathies/complications , Diabetic Neuropathies/diagnosis , Diagnosis, Differential , Femoracetabular Impingement/complications , Femoracetabular Impingement/diagnosis , Humans , Intervertebral Disc Displacement/complications , Lumbar Vertebrae/injuries , Magnetic Resonance Imaging , Myelitis/diagnosis , Osteoarthritis, Hip/complications , Osteoarthritis, Hip/diagnosis , Peroneal Neuropathies/diagnosis , Spinal Neoplasms/complications , Spinal Neoplasms/diagnosis , Spinal Stenosis/diagnosisABSTRACT
OBJECTIVE: The purpose of this study was to determine the shape and measurements of the normal distal tibiofibular syndesmosis on computed tomographic scans and to identify features that could aid in the diagnosis of syndesmotic diastasis using computed tomography (CT). MATERIALS AND METHODS: CT scans of 100 patients with normal distal tibiofibular syndesmoses were reviewed retrospectively. In 67% the incisura fibularis was deep, giving the syndesmosis a crescent shape. In 33% the incisura fibularis was shallow, giving the syndesmosis a rectangular shape. The measurements of both types were taken using the same reference points. RESULTS: The mean age of the patients was 40 years, and there were 53 men and 47 women. The mean width of the distal tibiofibular syndesmosis anteriorly between the tip of the anterior tibial tubercle and the nearest point of the fibula was 2 mm. The mean width of the distal tibiofibular syndesmosis posteriorly between the medial border of the fibula and the nearest point of the lateral border of the posterior tibial tubercle was 4 mm. In men the mean width of the distal tibiofibular syndesmosis, anterior and posterior, was 2 mm and 5 mm, respectively, and in women it was 2 mm and 4 mm, respectively. CONCLUSION: This study provides measurements of the normal tibiofibular syndesmosis to aid in the diagnosis of occult diastasis.
