Case 311

Case 311

Medical history

A 69-year-old female patient reports abdominal and lumbar high-intense piercing pain with radiation to the medial and the lateral face of the lower limbs, exacerbated with a passive mobilization of the limb that started about one month ago. In use of ciprofloxacin for treatment of urinary tract infection. At examination: preserved general condition, afebrile, hemodynamically stable, muscle strength in limbs quantified in 4 (0-5) by Medical Research Council (MRC) scale and allodynia in the soles of the feet. CRP: 249 mg / dL.


Image 1: Magnetic resonance imaging (MRI) of the thoracolumbar spine, sagittal T1, without contrast.

Image 2: MRI of the thoracolumbar spine, sagittal T1 FAT, with intravenous contrast (gadolinium).

Image 3: MRI of the thoracolumbar spine, sagittal T2.

Image 4: MRI of the spine in the segment comprised between T12-L4. Axial T2 (upper) and axial T1 FAT (lower).

According to the case and the exposed images, the probable diagnosis is:

Test question

Secretary of State for Health - ES (SESA / ES) 2013. Center for Selection and Promotion of UnB Events (CESPE)

In relation to low back pain, one of the pathologies that most incapacitate the individuals of economically active age, mark the correct option.