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A 41-year-old man gave a 1-week history of very intense lower back pain, which radiated down the right posterolateral thigh, to the anterior tibia and the dorsum of the foot. He had previously undergone a renal transplantation. On examination, Lasègue’s sign was positive on the right. The medial hamstring reflex was absent on the right but normal on the left (figure 1 and online supplemental video). MR scan of lumbar spine showed a voluminous extruded disc herniation with compression of the descending right L5 nerve root (figure 2). Electromyography showed decreased recruitment of motor unit action potentials in the tibialis anterior and gluteus medius muscles (L5 myotomal pattern).
Contributors EGdCN—acquisition of data and literature review. MFG—acquisition of data and literature review. MM—acquisition of data and literature review. BMDC—acquisition of data and literature review. AMH—critical revision of manuscript for intellectual content and study supervision. FTR—critical revision of manuscript for intellectual content and study supervision.
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 for publication Consent obtained directly from patient(s).
Provenance and peer review Not commissioned. Externally peer reviewed by Robert Hadden, London, UK.
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