J Korean Orthop Assoc.  2009 Jun;44(3):395-400. 10.4055/jkoa.2009.44.3.395.

Restless Legs Syndrome Mimicking Lower Leg Pain of Spinal Origin :Report on Two Cases

• Shim DM
• Kim TK
• Oh SK
• Kim BG
• Bae KH

• KMID: 2186350
• DOI: http://doi.org/10.4055/jkoa.2009.44.3.395

Abstract

Restless legs syndrome (RLS) is a neurogenic disorder with the patients having a sensation of discomfort and an urge to move continuously. These symptoms can get worse during night and cause sleep disturbance. These symptoms can be misdiagnosed as lower leg pain of a spinal origin and the treatment can be wrongly focused on this. This treatment for an unproven state of symptoms can place clinicians in a difficult situation. We experienced RLS associated with spondylolisthesis and spinal stenosis, and we originally misdiagnosed the patient and wrongly treated the patient operatively with spinal fusion and posterior instrumentation. After an insufficient result, we diagnosed the patient with having RLS with the help of the neurology department and rehabilitation medical department. In one other case we diagnosed a RLS patient with the help of a neurologist and the patients had arrived an our department for total knee arthroplasty and spinal root block. We report on these cases so other orthopedic surgeons will not make same mistakes.

Keyword

Restless legs syndrome (RLS)

MeSH Terms

Arthroplasty
Humans
Hypogonadism
Knee
Leg
Mitochondrial Diseases
Neurology
Ophthalmoplegia
Orthopedics
Restless Legs Syndrome
Sensation
Spinal Fusion
Spinal Nerve Roots
Spinal Stenosis
Spondylolisthesis
Hypogonadism
Mitochondrial Diseases
Ophthalmoplegia

Figure

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  Fig. 1 Preoperative radiographs of the lumbar spine. Lateral radiograph showing spondylolisthesis at L4/5.

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  Fig. 2 Preoperative MRI imaging. MRI showed spinal stenosis at L4/5. B, L4/5; C, L4/5.

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  Fig. 3 Postoperative radiographs of the lumbar spine. Plane lumbar spine radiographs shows pedicle screw stabilization on L4/5.

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  Fig. 4 Radiograph of the right knee. Radiograph shows arthritic change of the knee.

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  Fig. 5 MRI imaging. MRI showed spinal stenosis at L4/5.

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