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Images in Neurology
Aug 2012

Thoracal Radiculopathy Owing to Disc Herniation

Arch Neurol. 2012;69(8):1080-1081. doi:10.1001/archneurol.2012.15

A sharp nonradiating pain suddenly developed in the right flank of a 59-year-old man. The pain lasted 3 hours, then disappeared completely. The next day, he noticed bulging of his right flank, with corresponding decreased sensibility. An abdominal wall herniation was suspected but abdominal ultrasound and computerized tomography were normal. The symptoms persisted, and he was seen by a neurologist 2 weeks after onset of the symptoms. Physical examination revealed a circumscribed right flank bulging, measuring 5 × 10 cm (Figure 1), with diminished sensibility to pain, touch, and temperature. Cerebrospinal fluid examination and fasting blood glucose results were within normal limits. Magnetic resonance imaging showed herniation and fragmentation of the T11-12 intervertebral disc (Figure 2). He was treated conservatively. On follow-up 4 months later, the bulging had diminished and the sensory disturbance was almost gone, causing him no discomfort.