Incidental abdominal aortic aneurysm on lumbosacral magnetic resonance imaging - a case series

Abstract

Magnetic resonance imaging (MRI) is commonly used as part of the assessment of patients presenting with leg/back pain to the orthopedic spinal outpatient clinic. Abdominal aortic aneurysm (AAA) can cause symptoms often similar to those of spinal stenosis. We report a case series of four patients who had incidental AAA detected on lumbosacral MRI. All patients were suffering from degenerative spinal disease and had been referred to the orthopedic spinal clinic. After history, examination and review of the imaging, all patients were referred to a vascular surgeon, and three were found to be completely asymptomatic from their aneurysm. One patient required open repair with an aortic graft due to the size of the aneurysm, although his symptoms were attributable to his spinal disease. All patients still required management of their degenerative spinal disease after their vascular review. We can find no other case reports of AAA as an incidental finding on lumbosacral MRI. This case series highlights the importance of looking at all aspects of our imaging and remembering the nonspinal causes of back and leg pains. Furthermore, in the presence of AAA when managing patients in the orthopedic outpatient setting, the authors recommend vascular review before offering orthopedic interventional management options to these patients.