Lumbar Plexus Disorders Presenting as Low Back Pain: A Narrative Review of a Practical Diagnostic Imaging Approach

Radiological and Anatomical Perspectives in Back Pain: From Pathoanatomy and Imaging Diagnosis to Clinical Management

Back pain is a leading cause of disability worldwide and represents a significant clinical and socioeconomic challenge. Its multifactorial nature requires a comprehensive understanding of spinal anatomy, pathological mechanisms, and imaging findings to facilitate accurate diagnosis and effective management. This review aimed to synthesize current evidence on the anatomical and radiological perspectives of back pain, emphasizing spinal pathoanatomy, diagnostic imaging, clinicoradiological correlation, and imaging-guided clinical management. A comprehensive literature review was conducted using peer-reviewed publications retrieved from Scopus, Web of Science, ScienceDirect, DOAJ, and Google Scholar. Relevant studies were identified using predefined keywords related to back pain, spinal anatomy, musculoskeletal imaging, degenerative spinal disorders, and clinical management. The selected literature was critically evaluated and organized into thematic domains. The review demonstrates that vertebral structures, intervertebral discs, facet joints, ligaments, paraspinal muscles, neural elements, and sacroiliac joints collectively contribute to the pathogenesis of back pain. Contemporary imaging modalities, including radiography, computed tomography, magnetic resonance imaging, and emerging advanced techniques, play complementary roles in identifying structural abnormalities and guiding treatment. Accurate clinicoradiological correlation remains essential because imaging findings do not always correspond with symptom severity. Emerging technologies, including artificial intelligence and advanced imaging techniques, have further enhanced diagnostic precision and personalized patient care. Integrating anatomical knowledge with radiological evaluation and clinical assessment provides a comprehensive framework for diagnosing and managing back pain. Continued advances in imaging technology and multidisciplinary research are expected to improve diagnostic accuracy, optimize treatment strategies, and support precision medicine in spine care.

From Mystery to Cure: A Rare Case of Low Back Pain

Magnetic Resonance Imaging Patterns of the Lumbosacral Spine in Low Back Pain at LASUTH, Lagos: A Narrative Review of Findings and Clinical Implications

Dgenerative lumbar spine disease is the predominant cause of chronic low back pain among patients undergoing MRI at Lagos State University Teaching Hospital, and MRI remains an indispensable diagnostic tool for identifying clinically significant spinal abnormalities.

Differentiating Sciatica from Hip Osteoarthritis: Diagnostic Challenges and the Role of the Athena Sign

Background/Objectives: Sciatica and hip osteoarthritis (OA) are common causes of lower extremity pain and functional impairment. Because both conditions may produce overlapping symptoms, distinguishing them can be challenging. Misdiagnosis may lead to inappropriate treatment, delayed intervention and unnecessary procedures. In addition, the frequent coexistence of hip and lumbar degenerative pathology, commonly referred to as hip–spine syndrome, further complicates diagnostic evaluation. This review aims to examine current diagnostic strategies used to differentiate lumbar radiculopathy from hip OA and to introduce the Athena Sign, which is presented as a preliminary, hypothesis-generating clinical observation requiring prospective validation. Methods: A narrative review of the literature was performed focusing on the pathophysiology, clinical presentation, differential diagnosis, physical examination and imaging evaluation of sciatica and hip OA. Particular emphasis was placed on clinical examination techniques and diagnostic injections used to identify the primary pain generator. Results: Both conditions share overlapping symptom patterns and inflammatory mechanisms, which may obscure the source of pain. Careful assessment of gait, hip range of motion, neurological findings and provocative maneuvers remains essential for accurate diagnosis. Imaging findings should be interpreted in conjunction with clinical examination due to the high prevalence of asymptomatic degenerative changes. The Athena Sign, observed with internal and external rotation of the hips in a prone position with the knee flexed, is associated with anterior intra-articular hip pathology and may provide an additional diagnostic indicator in patients with ambiguous hip–spine presentations. Conclusions: A systematic diagnostic approach integrating clinical examination, imaging and targeted diagnostic injections is essential for distinguishing between lumbar radiculopathy and hip OA. Recognition of dynamic clinical findings such as the Athena Sign may further improve diagnostic accuracy and guide appropriate management in patients presenting with overlapping hip and lumbar symptoms.

Sciatica: Evaluation and Management in Orthopedic Spine Patients.

Sciatica is a common condition in middle-aged and older adults, typically presenting as unilateral low back and buttock pain radiating down the posterior leg. Additional symptoms may include paresthesia and weakness. Common causes include disc herniation, lumbar spinal stenosis, spondylolisthesis, vertebral fractures, and, more rarely, congenital stenosis or tumors. Patients frequently report inciting events such as heavy lifting. Initial evaluation includes radiographs to assess bony abnormalities, while magnetic resonance imaging remains the gold standard for identifying nerve root compression. Most cases resolve within 3 months with activity modification alone. Conservative management, such as physical therapy, oral medications, and epidural steroid injections, may be pursued for persistent symptoms, while surgery is reserved for progressive neurological deficits or significant functional impairment. Through multidisciplinary collaboration, orthopedic nurses play a key role in educating patients on proper biomechanics, managing symptoms, and monitoring for specific signs and symptoms that may indicate more serious pathology.

Extraspinal Sciatic Neuropathy: MR-Based Compartment-Guided Evaluation and Radiologic Diagnostic Framework