EURORAD ESR

Case 14336

Leg Weakness and Sciatic Neuropathy due to Large Internal Iliac Aneurysm: an atypical presentation

Author(s)
Renan Ibrahem Adam1
Kateryna Arlachova1
Yuriy Arlachov2
Dr Julia Fairbairn3

Nottingham University Hospitals NHS Trust; Derby road, Nottingham, NG7 2UH
 
Patient
male, 83 year(s)
 
 
  • Figure 1
    MRI T2W of the pelvis
     

    MRI T2W axial image of the pelvis demonstrates a large right internal iliac aneurysm extending through the greater sciatic notch.

     
    Area of Interest: Musculoskeletal system; Vascular; Imaging Technique: MR; Procedure: Education; Special Focus: Aneurysms;

    MRI T2W coronal image of the pelvis demonstrates a large right internal iliac aneurysm extending through the greater sciatic notch.

     
    Area of Interest: Musculoskeletal soft tissue; Pelvis; Vascular; Imaging Technique: MR; Procedure: Ablation procedures; Special Focus: Tissue characterisation;
     
     
  • Figure 2
    MRI T2W Sagittal image of the pelvis

    The right internal iliac aneurysm (yellow arrow) is emerging through the greater sciatic notch and compressing the sciatic nerve (white arrow) at the inferior margin of the notch.

     
    Area of Interest: Musculoskeletal soft tissue; Pelvis; Imaging Technique: MR; Procedure: Embolisation; History; Special Focus: Pathology;
     
     
  • Figure 3
    MRI T1W and STIR coronal images of the pelvis

    There is some oedematous change around the proximal right sciatic nerve as it passes through the deep gluteal space. No oedema or atrophic changes within the hamstring muscles.

     
    Area of Interest: Musculoskeletal soft tissue; Imaging Technique: MR; Procedure: Imaging sequences; Special Focus: Pathology;
     
     
  • Figure 4
    CT angiogram axial image of the pelvis.

    Right internal iliac artery aneurysm with a focal saccular outpouching through the greater sciatic notch with pressure erosion of the sacrum and borders of the sciatic notch.

     
    Area of Interest: Musculoskeletal system; Pelvis; Vascular; Imaging Technique: CT; Procedure: Ablation procedures; Special Focus: Aneurysms; Tissue characterisation;
     
     
MRI T2W axial image of the pelvis demonstrates a large right internal iliac aneurysm extending through the greater sciatic notch.
 
MRI T2W coronal image of the pelvis demonstrates a large right internal iliac aneurysm extending through the greater sciatic notch.
 
The right internal iliac aneurysm (yellow arrow) is emerging through the greater sciatic notch and compressing the sciatic nerve (white arrow) at the inferior margin of the notch.
 
There is some oedematous change around the proximal right sciatic nerve as it passes through the deep gluteal space. No oedema or atrophic changes within the hamstring muscles.
 
Right internal iliac artery aneurysm with a focal saccular outpouching through the greater sciatic notch with pressure erosion of the sacrum and borders of the sciatic notch.
 
 
 
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