Differential Diagnosis for Acute Radicular Pain and Foot Drop
Single Most Likely Diagnosis
- Lumbar Disc Herniation: This is the most common cause of acute radicular pain and foot drop, especially if the pain is localized to the lower back and radiates down to the leg. Herniation of the lumbar disc can compress the nerve roots, leading to radiculopathy and symptoms like foot drop.
Other Likely Diagnoses
- Lumbar Spinal Stenosis: This condition involves narrowing of the spinal canal, which can compress the nerve roots and cause radicular pain and foot drop, especially in older adults.
- Spondylolisthesis: A condition where one of the vertebrae slips out of place, potentially compressing nerve roots and causing radicular symptoms.
- Peripheral Nerve Injury: Direct injury to the peroneal nerve can cause foot drop, and if associated with trauma or compression, it could present with acute radicular pain.
Do Not Miss Diagnoses
- Cauda Equina Syndrome: A serious condition where the nerves in the spinal canal are compressed, leading to severe pain, numbness, and potentially permanent nerve damage if not promptly treated. It's crucial to identify this condition early due to its potential for severe and irreversible consequences.
- Spinal Epidural Abscess: An infection that can compress the spinal cord or nerve roots, leading to severe pain, neurological deficits, and potentially life-threatening if not treated promptly.
- Spinal Tumor: Tumors in the spine can compress nerve roots, leading to radicular pain and neurological deficits like foot drop. Early diagnosis is critical for effective treatment.
Rare Diagnoses
- Diabetic Amyotrophy: A condition associated with diabetes that can cause severe pain, muscle weakness, and wasting, potentially leading to foot drop.
- Chronic Inflammatory Demyelinating Polyneuropathy (CIDP): An autoimmune disorder that can cause progressive nerve damage, leading to weakness, numbness, and potentially foot drop.
- Neurosyphilis: A rare condition caused by syphilis infection of the nervous system, which can lead to a variety of neurological symptoms, including pain and weakness.