Images in Neuroscience: Question
An unusual cause for chronic right-sided abdominal pain: question

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Clinical background

A 66-year-old woman presented with a 3 year history of pain in the right upper abdominal quadrant, with radiation to the right groin and upper thigh. She had been previously investigated extensively, with normal colonoscopies and abdominal imaging. Her pain had increased over a period of 4 months, had a “shooting” quality and was exacerbated by changes in position but was relieved by walking. She described minimal thoracic back pain. There was no reported lower limb weakness or numbness, no

The most likely diagnosis is:

A. Ossification of the posterior longitudinal ligament

B. Metastasis

C. Meningioma

D. Herniated thoracic disc

Answer on page 2259.

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    2021, Journal of Clinical Neuroscience
    Citation Excerpt :

    Neurological pathology of spinal origin has been a recognised part of the differential diagnosis of abdominal pain for generations of surgeons [2]. Thoracic spinal pathology with radicular (nerve root) involvement often presents with a ‘band-like’ patch of sensory disturbance which can radiate into a distribution incorporating the dermatomes of the abdomen [3,4]. Commonly encountered pathologies might include thoracic disc prolapse, syrinx, peripheral nerve sheath tumours or metastatic spinal deposits causing radicular irritation or compression [5,6].

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