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Rare extraspinal cause of acute lumbar radiculopathy
  1. Vinicius Tieppo Francio1,
  2. Brandon Barndt2,
  3. Justin B Schappell3,
  4. Travis Allen1,
  5. Chris Towery1,
  6. Saeid Davani1
  1. 1College of Medicine, University of Science, Art and Technology, Olveston, BWI, Montserrat
  2. 2Philadelphia College of Osteopathic Medicine, Philadelphia, Pennsylvania, USA
  3. 3John P and Katherine G McGovern Medical School, University of Texas, Houston, Texas, USA
  1. Correspondence to Dr Vinicius Tieppo Francio, vinicius.francio{at}


A 60-year-old man presented to an outpatient pain management clinic with antalgic gait and left lower extremity (LLE) radiculopathy from an unknown aetiology. A lumbar MRI revealed minimal disc protrusion at L3 and a partially visualised left-sided kidney abnormality. Abdominal and pelvic CT demonstrated severe hydronephrosis of the left kidney compressing the left psoas major. The patient was immediately referred to an outside hospital for nephrology workup, and following nephrostomy tube, his radicular pain resolved. He remained asymptomatic at 4 weeks follow-up. We found two cases of postsurgical, retroperitoneal fluid collection that caused lumbar radiculopathy, but none associated with hydronephrosis. To our knowledge, this is the first case in the literature to report hydronephrosis as the potential aetiology of lumbar radiculopathy, which highlights an important clinical reminder: to consider extraspinal aetiologies in all patients who present with lumbar radiculopathy, when clinical symptoms, examination findings and diagnostic studies present with unusual characteristics.

  • pain (neurology)
  • renal intervention
  • renal medicine
  • musculoskeletal syndromes
  • back pain

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  • Contributors Dr Travis Allen and Dr Chris Towery are also additional co-authors of this manuscript. Authorship form has been attached. All authors equally contributed to this manuscript with conception and design, acquisition of data, analysis, interpretation, drafting of the article, revision of intellectual content. All authors approved the version attached and are in agreement and accountable for the article. VTF was responsible for case description, review of the literature, planning, data gathering, reviewing and submission. BB was responsible for grammar review, review of the literature, case descriptions, planning and discussion. JBS was responsible for grammar and syntax review, literature review, bibliography and discussion. SD was responsible for reviewing the literature, clinical management guidelines, discussion of results and planning. TA was responsible for grammar review, literature review, bibliography planning and discussion. CT was responsible for literature review, discussion of case report, gathering data and planning.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.