Abstract
A 71-year-old man complained of pain in the right leg that gradually increased over a 2-week period. Pain was not related to any traumatic event. One year before this event, the patient underwent endovascular aortic repair for a ruptured abdominal aortic aneurysm. In addition, he had been administered oral prednisolone 10 mg/day to treat interstitial pneumonia in the last 2 years. Although the patient had no spinous process tenderness or abnormal neurological symptoms in the lower legs, moderately weakened muscle and sensory disturbance of the right thigh were observed. Lumbar X-ray images and magnetic resonance imaging revealed a fracture of the second lumbar vertebra. The patient underwent conservative therapy using a thoracolumbar corset. The symptoms improved after 3 months. We recommend that primary care physicians should not rule out vertebral fractures despite a lack of evidence of spinous process tenderness or abnormal neurological symptoms of the lower legs on physical examination. Neurological examination of the thigh should be performed in such cases.
