Figure 2

MRI visible nerve involvement though no physical examination findings. Figure 2abc: MRI of the lumbar spine of a man aged 48 years. T2-weighted sagittal right foraminal (a), sagittal right lateral (b) and axial L5-S1 (c) scans. The radiological assessment noted visible nerve involvement bilaterally at L5 and right-sided nerve involvement at S1 due to disc hernia and intervertebral arthrosis. Figure 2d: Pain drawing made by the patient in figure 2abc. The initial impression assessment of the pain drawing was that he had right-sided L4-S1 radiculopathy. No pathological findings were observed in the physical examination except that the right plantar reflex was slightly impaired. Patient history included 9 years of walking difficulties but no back pain. Symptoms started when he carried a heavy weight. Walking or standing still for 5 minutes made his right leg cramp and feel numb, like "lots of lactic acid". Bending forward relieved the pain.