J Korean Neurosurg Soc.  2005 Aug;38(2):144-146.

Multi-access for the Diagnosis of Missed Upper Lumbar Disc Herniation

• Lee DY
• Kim HS
• Lee SH

Abstract

Herein, a case of missed upper lumbar disc herniation, diagnosed by thorough neurological examination, digital infrared thermographic imaging(DITI), and repeated magnetic resonance(MR) image study, is reported. A 36-year-old female presented with intractable leg pain on left anterior thigh. Although she underwent lumbar MR image at other hospital, she was misdiagnosed as acute sprain. Neurological examination suggested the possibility of upper lumbar disc herniation, which was confirmed by DITI, MRI, and selective root block. After operation, her leg pain was significantly improved. It should be considered that upper lumbar disc herniation might be misdiagnosed as an acute sprain, as in our case. A high index of suspicion based on thorough neurological examination is most important in such cases. Then, multi-access such as DITI, MR image, and selective block, base on thorough neurological examination, are warranted.

Keyword

Upper lumbar disc herniation; Neurologic examination; Digital infrared thermographic imaging(DITI)

MeSH Terms

Adult
Diagnosis*
Female
Humans
Leg
Magnetic Resonance Imaging
Neurologic Examination
Sprains and Strains
Thigh