A 61-year-old woman, administrative, with a history of overweight, hypertension, dyslipidemia and metabolic syndrome, who consults for pain in both buttocks, left trochanteric region, lateral aspect of the left thigh up to the knee and left leg up to the middle third. The pain appears when the lower limb is lifted with the knee extended, but is relieved when the knee is flexed. What is the first clinical suspicion?
The most common symptomatology of a patient with coxarthrosis includes: hip pain that limits ambulation, nocturnal discomfort and even at rest, hip stiffness and locking. Coxo-femoral osteoarthrosis presents with a negative Lasegue test. Wrong answer 2. Low back pain of a neuropathic nature usually presents with unilateral and distributed radiculopathy according to dermatomes. The recognized risk factors are most frequently: women, obesity, smoking and sedentary lifestyle or situations of prolonged sitting. The lumbosciatica is usually referred to the buttock, posterior aspect of the thighs and even inguinal. The clinical case describes the Lasegue maneuver or test; a provocation test that evidences radicular irritation in the lumbosacral region (Answer 3 correct). Claudication due to canal stenosis typically presents with pain that worsens with trunk extension (walking, standing) and is relieved with flexion (sitting, sleeping in the fetal position...) Wrong answer 4.
Gouty arthritis of the left hip.
Left coxofemoral arthrosis.
Radiated low back pain / lumbosciatica.
Claudication due to canal stenosis.
Coxo-femoral osteoarthrosis presents with a negative Lasegue test. Wrong answer 2.
The clinical case describes the Lasegue maneuver or test; a provocation test that evidences radicular irritation in the lumbosacral region (Answer 3 correct).
Claudication due to canal stenosis typically presents with pain that worsens with trunk extension (walking, standing) and is relieved with flexion (sitting, sleeping in the fetal position...) Wrong answer 4.