Noh Kyudong, Jung Jong Burm, Seong Jeong Won, Kim Doh-Eui, Kwon Dongrak, Kim Yuntae
Department of Physical Medicine and Rehabilitation, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon, Korea.
Department of Physical Medicine and Rehabilitation, Soonchunhyang University Cheonan Hospital, Soonchunhyang University College of Medicine, Cheonan, Korea.
Ann Rehabil Med. 2020 Feb;44(1):85-89. doi: 10.5535/arm.2020.44.1.85. Epub 2020 Feb 29.
Flank pain is a common reason for visits to the emergency room. The most common reason warranting hospital visits are urology-related problems. However, there are many other causes, such as musculoskeletal lesions, that difficult to achieve a correct diagnosis. Here, we describe a rare case of flank pain caused by thoracolumbar junction syndrome, accompanying renal artery stenosis. A 54-year-old male with hypertension presented with severe left flank pain for 1 week. Initially, he was diagnosed with left renal artery stenosis by computed tomography and decreased renal function on renal scan (Tc-99m DTPA). Although a stent was inserted into the left renal artery, flank pain persisted with only minor improvement. Through detailed physical examination, he was finally diagnosed with thoracolumbar junction syndrome. After three injections in the left deep paravertebral muscles at the T10-T12 levels, flank pain completely ceased. Clinicians must consider thoracolumbar junction syndrome, when treating patients with flank pain.
胁腹疼痛是急诊就诊的常见原因。需要住院治疗的最常见原因是与泌尿外科相关的问题。然而，还有许多其他原因，如肌肉骨骼病变，难以做出正确诊断。在此，我们描述一例罕见的由胸腰段交界综合征伴肾动脉狭窄引起的胁腹疼痛病例。一名54岁高血压男性出现严重左侧胁腹疼痛1周。最初，通过计算机断层扫描诊断为左肾动脉狭窄，肾扫描（Tc-99m二乙三胺五乙酸）显示肾功能下降。尽管在左肾动脉置入了支架，但胁腹疼痛持续存在，仅略有改善。通过详细的体格检查，最终诊断为胸腰段交界综合征。在T10 - T12水平的左侧椎旁深部肌肉注射三次后，胁腹疼痛完全消失。临床医生在治疗胁腹疼痛患者时必须考虑胸腰段交界综合征。
