Turkish Journal of Geriatrics 2014 , Vol 17, Issue 2
THORACOLUMBAR JUNCTION SYNDROME: AN OVERLOOKED DIAGNOSIS IN AN ELDERLY PATIENT
Ä°lknur AKTAÅž1, Kenan AKGÃœN2, Deniz PALAMAR2, Merih SARIDOÄžAN2
1Fatih Sultan Mehmet Education and Research Hospital, Department of Physical Medicine and Rehabilitation, Ä°STANBUL
2Istanbul University, Cerrahpasa Medical Faculty, Department of Physical Medicine and Rehabilitation Ä°STANBUL
Thoracolumbar junction syndrome is defined as a result of a minor intervertebral dysfunction at the thoracolumbar junction and referred pain in the low back and hip region, and can often be confused with other pathologies that may cause these symptoms.

A 65-year-old woman with nearly two years of continuous throbbing pain in the low back, right hip and groin region who was scheduled for spinal surgery with the diagnosis of spinal stenosis in the neurosurgery clinic was referred to our clinic for consultation. Physical examination revealed severe limitation of the passive and active range of motion of the lumbar spine, and pain in all directions. There was tenderness at the T12-L1, L5-S1 and L4-L5 intervertebral spaces and at the T12, L1, L4 and L5 spinous processes. On the right side, the maneuver of lateral pressure against the spinous process at the level of T12, the pinch-roll test and the posterior iliac crest point sign were positive. Tenderness over the trochanteric region and the superior aspect of the pubis was detected on the right side. All tests were negative after a right T12 periapophyseal joint block using a local anesthetic, with the prediagnosis of thoracolumbar junction syndrome. The patient was diagnosed with thoracolumbar junction syndrome and treated with conservative methods.

Thoracolumbar junction syndrome is a pathology that should be considered in the differential diagnosis in elderly patients with low back, hip and groin pain. Keywords : Low Back Pain; Iliac, Lumbar; Thoracic; Vertebrae; Aged