An 83-year-old man presented with severe left anterolateral thigh and knee pain for several days. He was completely unable to ambulate owing to the pain. The patient reported no history of acute back pain prior to presentation. His history initially confounded diagnosis. Subsequent investigations demonstrated a chronic contained rupture of an infrarenal aortic aneurysm with significant vertebral body erosion and obliteration of the ipsilateral psoas muscle. Proposed symptomatology was compression of the lateral femoral cutaneous nerve and its roots. The patient had multiple medical comorbidities and died of unrelated causes before his aneurysm was able to be repaired.
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