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A Journal on Physical Medicine and Rehabilitation after Pathological Events

Official Journal of the Italian Society of Physical and Rehabilitation Medicine (SIMFER), European Society of Physical and Rehabilitation Medicine (ESPRM), European Union of Medical Specialists - Physical and Rehabilitation Medicine Section (UEMS-PRM), Mediterranean Forum of Physical and Rehabilitation Medicine (MFPRM), Hellenic Society of Physical and Rehabilitation Medicine (EEFIAP)
In association with International Society of Physical and Rehabilitation Medicine (ISPRM)
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Europa Medicophysica 1998 June;34(2):75-83

language: English

Common pseu­do­ra­dic­u­lar syn­dromes (pseudocrural and pseudosciatic pain)

Rucco V., Onorato A.

Rehabilitation Unit, Physical Medicine and Rehabilitation Hospital, Udine, Italy


The pseu­do­cru­ral and pseu­do­sciat­ic syn­dromes are clin­i­cal syn­dromes ­which ­cause ­pain in the low­er ­limbs, involv­ing the ­same are­as of the lum­bar der­ma­tomes but not the lum­bar ­nerve ­roots. Although pseu­do­ra­dic­u­lar syn­dromes may be ­caused by a varie­ty of dis­eas­es, ­many of ­these are ­quite ­rare. In ­this ­review the ­benign caus­es of pseu­do­ra­dic­u­lar syn­dromes (name­ly, ­those ­that are ­more com­mon but ­less seri­ous ­since ­they are cur­able) are examined. These syn­dromes can ­appear ­alone, coex­ist ­with a com­pres­sive ­nerve ­root syn­drome or ­else ­arise fol­low­ing the remov­al of the nucle­us pul­po­sus (by chem­o­nu­cle­ol­y­sis, Onik’s per­cut­ane­ous dis­cec­to­my by aspi­ra­tion or con­ven­tion­al ­open dis­cec­to­my). The clin­i­cal dif­fer­enc­es ­between radic­u­lar syn­dromes and pseu­do­ra­dic­u­lar syn­dromes are exam­ined and ­these ­forms are sub­di­vid­ed ­into two ­main ­groups on the ­basis of ­their under­ly­ing mech­a­nisms: pseu­do­ra­dic­u­lar syn­dromes due to ­reflex mech­a­nisms (zyga­poph­y­seal ­joint syn­drome, ili­o­lum­bar syn­drome, hip ­joint pathol­o­gy) and pseu­do­ra­dic­u­lar syn­dromes due to a pathol­o­gy of an ana­tom­i­cal struc­ture of the low­er ­limb (fibro­myal­gia, myo­fas­cial ­pain syn­dromes, ten­di­nop­a­thies of the low­er ­limbs, fas­cia ­lata and ili­o­ti­bi­al ­band pathol­o­gy, pir­i­for­mis syn­drome, ischi­at­ic tube­ros­ity frac­ture, periph­er­al ­nerve entrap­ment). Finding the ­cause of radic­u­lar ­pain is by no ­means an ­easy ­task, and no phy­si­cian can ­admit to nev­er hav­ing ­made a mis­take. Although the lat­est imag­ing tech­niques and ­close col­lab­o­ra­tion ­among cli­ni­cians, neu­ro­ra­diol­o­gists and neu­ro­sur­geons can do ­much to ­reduce the mar­gin of ­error, it is all but impos­sible to elim­i­nate it entire­ly.

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