Select a Community
Are you sure you want to trigger topic in your Anconeus AI algorithm?
You are done for today with this topic.
Would you like to start learning session with this topic items scheduled for future?
Figure A
8%
241/2848
Figure B
11%
310/2848
Figure C
28%
785/2848
Figure D
18%
505/2848
Figure E
35%
989/2848
Select Answer to see Preferred Response
The patient presents with a right sided L5 radiculopathy. The only axial MRI image that would cause a right L5 radiculopathy is Figure E, a far lateral L5/S1 disc herniation. Radiculopathy secondary to a herniated lumbar disc can affect either the traversing nerve root or the exiting nerve root. Paracentral disc herniations are most common, and they affect the traversing nerve root, i.e. an L5/S1 paracentral disc herniation will cause S1 symptoms. Occasionally disc herniations are far lateral. In these cases, the disc herniation affects the exiting nerve root, i.e. an L5/S1 far lateral disc herniation will cause L5 symptoms. Tamir et al reported that far lateral disc herniations are more common at L3/4 than L4/5 or L5/S1. Additionally, L3/4 disc herniations are more likely to be in older patients, and neurologic deficits are common. Rhee et al. published a review on the anatomy, pathophysiology and treatment options for lumbar herniated discs. Illustration A is a schematic showing how paracentral and far lateral disc herniations affect the traversing and exiting nerve roots respectively. Illustration B labels the anatomic structure in the axial MRI in Figure E. Incorrect Answers: Answer 1: This is a far lateral disc herniation at L4/5. This would present with right L4 symptoms Answer 2: This is a facet cyst at L4/5. It would present with left L5 symptoms Answer 3: This is a paracentral disc herniation at L3/4. This would present with right L4 symptoms Answer 4: This is a paracentral disc herniation at L5/S1. This would present with right S1 symptoms
3.1
(72)
Please Login to add comment