RI Spine Center, Providence, RI 02860, USA.
Spine (Phila Pa 1976). 2010 Nov 15;35(24):E1435-7. doi: 10.1097/BRS.0b013e3181e8ab84.
Case report.
To present the case of a patient with low back and lower extremity pain suspected to result from lumbar radiculopathy but who was discovered to have symptomatic uterine fibroid (UF).
UFs are usually asymptomatic but at times can produce symptoms such as excessive menstrual bleeding, intermenstrual bleeding, dysmenorrhea, pelvic pain, pelvic pressure, bloating, dyspareunia, urinary and bowel disturbance, subfertility, and pregnancy-related complications. In rare cases, they can cause neural impingement leading to lower extremity pain, which can be mistaken for lumbar radiculopathy.
The patient was a 44-year-old woman who presented with low back pain and left leg pain. Examination suggested lumbar radiculopathy but lumbar magnetic resonance imaging was negative with the exception of a large mass in the pelvis. Pelvic magnetic resonance imaging confirmed this to be a large UF.
The patient's symptoms completely resolved following hysterectomy.
In a female patient with suspected radiculopathy, in whom lumbar imaging is negative, or who does not respond as expected to treatment, UF should be considered.
病例报告。
报告一例疑似因腰椎神经根病变引起的下腰痛和下肢痛的患者，但最终发现其患有症状性子宫肌瘤（UF）。
UF 通常无症状，但有时会出现月经过多、经间期出血、痛经、盆腔痛、盆腔压迫感、腹胀、性交困难、尿便障碍、不孕和与妊娠相关的并发症等症状。在极少数情况下，它们可能会导致神经受压，引起下肢疼痛，这可能被误诊为腰椎神经根病变。
患者为 44 岁女性，表现为腰痛和左腿痛。检查提示腰椎神经根病变，但腰椎磁共振成像（MRI）除了盆腔内有一个大肿块外，无其他异常。盆腔 MRI 证实这是一个大的 UF。
患者的症状在子宫切除术后完全缓解。
对于疑似神经根病变的女性患者，如果腰椎影像学检查为阴性，或对治疗无预期反应，应考虑 UF。
