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Lift the quilt in case of atrial fibrillation and disc prolapse
BACKGROUND: Peripheral embolism to the lower extremities may mimic disc prolapse with severe consequences. CASE REPORT: A 71-year-old male with a history of chronic alcoholism developed low back pain radiating to both lower extremities in a nonradicular distribution and bilateral dysesthesias of the...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Dove Medical Press
2012
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3390994/ https://www.ncbi.nlm.nih.gov/pubmed/22787404 http://dx.doi.org/10.2147/VHRM.S31156 |
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author | Bastovansky, Adam Ziegler, Kathrin Stöllberger, Claudia Finsterer, Josef |
author_facet | Bastovansky, Adam Ziegler, Kathrin Stöllberger, Claudia Finsterer, Josef |
author_sort | Bastovansky, Adam |
collection | PubMed |
description | BACKGROUND: Peripheral embolism to the lower extremities may mimic disc prolapse with severe consequences. CASE REPORT: A 71-year-old male with a history of chronic alcoholism developed low back pain radiating to both lower extremities in a nonradicular distribution and bilateral dysesthesias of the distal lower legs after lifting a heavy weight. Given that magnetic resonance imaging (MRI) of the lumbar spine showed disc herniation in L3/4 and L4/5, he was scheduled for laminectomy but was unable to undergo surgery due to thrombocytopenia. After transfer to another hospital, persistence of symptoms and signs, absent pulses on the distal lower legs, and rhabdomyolysis with temporary renal insufficiency, peripheral embolism with compartment syndrome was suspected. Magnetic resonance angiography revealed occlusion of the right superficial femoral artery and long high-grade stenosis of the left superficial and profound femoral arteries and distal arteries. He successfully underwent embolectomy and fasciotomy. CONCLUSIONS: If lumbar pain is not radicular, peripheral pulses are minimally palpable, and distal limbs are cold and show livid decolorization, peripheral embolism is much more likely than disc herniation, particularly if the patient’s history is positive for atrial fibrillation. MRI of the lumbar spine must be interpreted in conjunction with clinical presentation. |
format | Online Article Text |
id | pubmed-3390994 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2012 |
publisher | Dove Medical Press |
record_format | MEDLINE/PubMed |
spelling | pubmed-33909942012-07-11 Lift the quilt in case of atrial fibrillation and disc prolapse Bastovansky, Adam Ziegler, Kathrin Stöllberger, Claudia Finsterer, Josef Vasc Health Risk Manag Case Report BACKGROUND: Peripheral embolism to the lower extremities may mimic disc prolapse with severe consequences. CASE REPORT: A 71-year-old male with a history of chronic alcoholism developed low back pain radiating to both lower extremities in a nonradicular distribution and bilateral dysesthesias of the distal lower legs after lifting a heavy weight. Given that magnetic resonance imaging (MRI) of the lumbar spine showed disc herniation in L3/4 and L4/5, he was scheduled for laminectomy but was unable to undergo surgery due to thrombocytopenia. After transfer to another hospital, persistence of symptoms and signs, absent pulses on the distal lower legs, and rhabdomyolysis with temporary renal insufficiency, peripheral embolism with compartment syndrome was suspected. Magnetic resonance angiography revealed occlusion of the right superficial femoral artery and long high-grade stenosis of the left superficial and profound femoral arteries and distal arteries. He successfully underwent embolectomy and fasciotomy. CONCLUSIONS: If lumbar pain is not radicular, peripheral pulses are minimally palpable, and distal limbs are cold and show livid decolorization, peripheral embolism is much more likely than disc herniation, particularly if the patient’s history is positive for atrial fibrillation. MRI of the lumbar spine must be interpreted in conjunction with clinical presentation. Dove Medical Press 2012 2012-06-22 /pmc/articles/PMC3390994/ /pubmed/22787404 http://dx.doi.org/10.2147/VHRM.S31156 Text en © 2012 Bastovansky et al, publisher and licensee Dove Medical Press Ltd. This is an Open Access article which permits unrestricted noncommercial use, provided the original work is properly cited. |
spellingShingle | Case Report Bastovansky, Adam Ziegler, Kathrin Stöllberger, Claudia Finsterer, Josef Lift the quilt in case of atrial fibrillation and disc prolapse |
title | Lift the quilt in case of atrial fibrillation and disc prolapse |
title_full | Lift the quilt in case of atrial fibrillation and disc prolapse |
title_fullStr | Lift the quilt in case of atrial fibrillation and disc prolapse |
title_full_unstemmed | Lift the quilt in case of atrial fibrillation and disc prolapse |
title_short | Lift the quilt in case of atrial fibrillation and disc prolapse |
title_sort | lift the quilt in case of atrial fibrillation and disc prolapse |
topic | Case Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3390994/ https://www.ncbi.nlm.nih.gov/pubmed/22787404 http://dx.doi.org/10.2147/VHRM.S31156 |
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