Ann Rehabil Med.  2014 Feb;38(1):132-137. 10.5535/arm.2014.38.1.132.

Right Calf Claudication Revealing Leriche Syndrome Presenting as Right Sciatic Neuropathy

• Yoon DH
• Cho H
• Seol SJ
• Kim T

• KMID: 2266552
• DOI: http://doi.org/10.5535/arm.2014.38.1.132

Abstract

The syndrome of aortoiliac occlusive disease, also known as Leriche syndrome, is characterized by claudication, pain, and diminished femoral pulse. We highlight an unusual case of right sciatic neuropathy caused by Leriche syndrome, which was initially misdiagnosed. A 52-year-old male, with a past medical history of hypertension and bony fusion of the thoracolumbar spine, visited our hospital complaining of right leg pain and claudication, and was initially diagnosed with spinal stenosis. The following electrophysiologic findings showed right sciatic neuropathy; but his symptom was not relieved, despite medications for neuropathy. A computed tomography angiography of the lower extremities revealed the occlusion of the infrarenal abdominal aorta, and bilateral common iliac and right external iliac arteries. All these findings suggested omitted sciatic neuropathy associated with Leriche syndrome, and the patient underwent a bilateral axillo-femoral and femoro-femoral bypass graft.

Keyword

Leriche syndrome; Sciatic neuropathy; Spinal stenosis

MeSH Terms

Angiography
Aorta, Abdominal
Humans
Hypertension
Iliac Artery
Leg
Leriche Syndrome*
Lower Extremity
Male
Middle Aged
Sciatic Neuropathy*
Spinal Stenosis
Spine
Transplants

Figure

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  Fig. 1 Thoracolumbar spine magnetic resonance imaging. (A) Sagittal view and (B) transverse view, of T10-11 intervertebral disc space on T2-weighted image show severe kyphotic curvature in the thoracolumbar spine, and central canal stenosis on the 10th and 11th thoracic vertebra level.

• 

  Fig. 2 Computed tomography angiography of the lower extremities. (A) 3D reconstruction images and (B) maximal intensity projection images, demonstrate an occlusion of the infrarenal abdominal aorta, and bilateral common iliac and right external iliac arteries.

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