Sacral PlexusClinical case and images provided by Avneesh Chhabra, M.D., Johns Hopkins University School of Medicine, Baltimore, USA

30-year-old man with 3 year history of pain involving the right lower extremity, at times, radiating into the bottom of the foot.

• Pain clearly aggravated by driving
• Patient had good range of motion of lumbar spine with no weakness
• Negative straight leg raise
• EMG showed a normal study without any denervation
• Patient referred to MR Neurography
• Patient's outside MR lumbar spine imaging showed slight asymmetry of the S1 root with the nerve appearing slightly enlarged
• No clear enhancement