Inflammatory low back pain with radiculopathy revealing epidural disintegration of a bullet complicated by lead poisoning

RMD Open. 2023 Dec 7;9(4):e003119. doi: 10.1136/rmdopen-2023-003119.

Abstract

Inflammatory low back pain with radiculopathy is suggestive of cancer, infection or inflammatory diseases. We report a unique case of a 42-year-old patient with an acute inflammatory low back pain with bilateral radiculopathy associated with weight loss and abdominal pain, revealing the disintegration of a lead bullet along the epidural space and the S1 nerve root complicated by lead poisoning. Because of the high blood lead level of intoxication (>10 times over the usual lead levels) and the failure of repeated lead chelator cycles, a surgical treatment to remove bullet fragments was performed. It resulted in a significant decrease of pain and lead intoxication.

Keywords: inflammation; low back pain; orthopedic procedures.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Humans
  • Lead
  • Lead Poisoning* / complications
  • Lead Poisoning* / diagnosis
  • Low Back Pain* / complications
  • Low Back Pain* / etiology
  • Radiculopathy* / diagnosis
  • Radiculopathy* / etiology

Substances

  • Lead