![]() Previous low back pain (LBP) and history of radiation pain in the right lower extremity, radiation pain in the right lower extremity this time 2. Thus, the patient was initially diagnosed as sciatica caused by lumbar disc herniation.ġ. Magnetic resonance imaging (MRI) implied that there was a lateral type disc protrusion on the right side in L4/5 which was in a condition of Modic II type degeneration, mildly pressing the lumbar 5th nerve on the right Figures 2, 3. X-ray showed that L4/5 intervertebral height was obviously collapsed ( Figure 1). There were no obvious abnormalities in laboratory tests such as blood routine, electrolyte, liver and kidney function, C-reactive protein, and erythrocyte sedimentation rate. Lasegue sign: left/right = −/+ (60°) Bragard sign: left/right = −/− Femoral nerve tension test: left/right = -/- Piriformis strain test: left/right = −/−. Knee reflex: left/right = + +/− ankle reflex: left/right = ++/+ pathological sign (−). L4/5, L5/S1 spinous process gap tenderness is positive limb sensation, muscle strength and muscle tension were all normal. There was no abnormalities in the appearance of the spine and limbs. Analgesics and neurotrophic drugs are almost ineffective. There was no lower back pain, weak walking, no intermittent claudication and other symptoms. Pain is not relieved by rest or changing posture. The pain was from the back of the right hip, behind the thigh, along the lateral crural region, and to the dorsum of foot. One month ago, there was radiation pain in the right lower limb. There were several attacks of the symptoms every year. It came on intermittently with radiation pain in the right lower limb. The pain can be relieved when rested in the supine position 4. The VAS (leg) score was 8–9 points and the VSA (lumbar) score was 0 point 3. Symptoms were aggravated in the upright lumbar forward flexion position 2. Case PresentationĪ 55-year-old male who was admitted to our hospital in 2019 developed lower back pain after carrying heavy items 20 years ago. Here we report a case a case of suspected lumbar disc herniation with sciatic herpes zoster to reduce the rate of misdiagnosis. Especially for the patients with a history of lumbar disc herniation and imaging of corresponding segments with nerve compression, it is easy to be confused ( 5). The identified risk factors for Hertz include oldness and immunosuppressive drugs ( 2– 4).Īlthough the lower extremity sciatic herpes zoster is rare clinically, its symptoms and signs are very similar to those of lumbar disc herniation. HZ is a reactivation of the latent varicella zoster virus infection, which can lead to a large incidence, especially in the elderly and patients with impaired immune function ( 1). Initial infection with varicella zoster virus (VZV) can cause acute illness (chickenpox), usually in children and young adults. Herpes zoster (HZ), often referred to as shingles or zona, is a kind of viral disease characterized by painful rashes with blisters in a limited area on one side of the body, usually in the form of streaks. ![]() After the application of antiviral drugs, the radiation pain in the right lower extremity was significantly relieved.Ĭonclusion: We describe this case in detail and discuss how to make an authentic diagnosis, with a concomitant literature review. Analgesics and neurotrophic drugs are ineffective. There was no back pain, no lower limbs, weak walking, no claudication and other symptoms. ![]() Pain could not be relieved by rest or changing posture. The pain was from the back of the right hip, behind the thigh, in lateral crural region, to the back of the foot. One month ago, there was radiating pain in the right lower limb. It can be relieved when rested in the supine position 4. We describe a case of suspected lumbar disc herniation with sciatic herpes zoster to reduce the rate of misdiagnosis.Ĭase Report: A 55-year old man, male, developed low back pain after carrying heavy items 20 years ago. 3Tangdu Hospital, Fourth Military Medical University, Xi'an, Chinaīackground: The symptoms of sciatic herpes zoster are sometimes difficult to distinguish from sciatica caused by lumbar disc herniation.2School of Basic Medicine, Fourth Military Medical University, Xi'an, China.1Department of Orthopeadics, Tangdu Hospital, Fourth Military Medical University, Xi'an, China.Fei-Long Wei 1 †, Tian Li 2 †, Yang Song 1, Lin-Ya Bai 3, Yifang Yuan 1, Chengpei Zhou 1, Jixian Qian 1 * and Xiaodong Yan 1 *
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