Low back pain (LBP) is one of the most common causes of medical consultation worldwide and is typically attributed to degenerative spinal disorders. However, a subset of patients presents with LBP related to extra-spinal conditions, including disorders of the lumbar plexus. These conditions are often underrecognized and may mimic lumbar radiculopathy, leading to delayed diagnosis or inappropriate management. The lumbar plexus, formed by the anterior rami of L1–L4 nerve roots, lies deep within the psoas muscle and can be affected by a wide range of pathological processes, including traumatic, compressive, inflammatory, infectious, and neoplastic conditions. A targeted literature search of the PubMed/MEDLINE database was performed to identify relevant English-language articles on lumbar plexus disorders, their imaging features, and diagnostic strategies published from inception to June 2026; representative imaging examples were selected from the co-authors’ clinical archives. The review summarizes the relevant anatomy, clinical presentation, and key imaging features of the most common plexus pathologies, including retroperitoneal tumors, psoas hematomas, inflammatory plexopathies, and iatrogenic injuries. Advances in imaging techniques, particularly magnetic resonance imaging (MRI) and magnetic resonance neurography (MRN), have significantly improved the ability to visualize the lumbar plexus and detect pathological changes involving peripheral nerves and surrounding structures. Additionally, a practical diagnostic imaging approach is proposed to assist radiologists and clinicians in recognizing lumbar plexus involvement in patients with atypical low back pain.
Federico Bruno, Raffaele Natella, Giorgio Reverchon et al.· Diagnostics· 0 citations
Background/Objectives: Low back pain (LBP) is highly prevalent among dentists, although the relationship between lumbar magnetic resonance imaging (MRI) findings and symptoms remains unclear. This study aimed to identify lumbar MRI-derived structural profiles in actively practicing dentists and to examine their relationship with LBP, pain-related disability, demographic characteristics, occupational factors, and individual MRI findings. Methods: A cross-sectional observational study was conducted in 57 actively practicing dentists. Demographic, occupational, and clinical data were collected, and lumbar MRI examinations were performed using standardized protocols. MRI findings included disc bulging, disc herniation, annular fissure, Modic changes, osteophytes, facet joint degeneration, and spinal canal stenosis. Cluster analysis was used to identify MRI-derived structural profiles. Associations between profiles, LBP, disability, demographic characteristics, occupational factors, and individual MRI findings were assessed using chi-square tests and correspondence analysis. Results: Two distinct MRI-derived structural profiles were identified: a disc–facet degenerative profile (n = 38) and a non-osseous degeneration profile (n = 19). Disc bulging (100% vs. 52.6%, p < 0.001), facet joint degeneration (94.7% vs. 10.5%, p < 0.001), and osteophytes (23.7% vs. 0%, p = 0.022) significantly contributed to profile differentiation, whereas disc herniation, Modic changes, and annular fissure did not. Neither MRI-derived profile was associated with the presence of LBP or pain-related disability (p > 0.05). Younger dentists were more frequently classified within the disc–facet degenerative profile with LBP, whereas older dentists with similar structural findings were more commonly classified within the same profile without LBP (p = 0.007). No significant associations were observed between MRI-derived profiles and occupational characteristics. Conclusions: Two distinct lumbar MRI-derived structural profiles were identified in dentists, but neither was associated with LBP or pain-related disability. Age appeared to influence the clinical expression of the disc–facet degenerative profile, suggesting that lumbar MRI findings should be interpreted within a broader, age-sensitive clinical context rather than as isolated determinants of symptoms.
Federico Bruno, F. Bini, Raffaele Natella et al.· Diagnostics· 0 citations