Purpose: to alert readers to the possibility of a ruptured abdominal aortic aneurysm presenting with femoral neuropathy and back pain.

Method: Our patient presented with a short history of left leg weakness, numbness and back pain but was otherwise in a stable condition. An MR of his lumbar spine was initially performed on a 1T GE scanner and this was followed by an abdominal ultrasound scan and a spiral CT on a Siemen’s Somatom with reconstructions.

Results: The MR unexpectedly demonstrated a large abdominal aortic aneurysm and swelling of the left psoas muscle. These features were observed easily as the saturation band was placed anterior to the retroperitoneum.

Ultrasound confirmed these findings and the subsequent CT demonstrated precisely the point of rupture with contrast entering the left psoas muscle.

Conclusion: Rupture of an abdominal aortic aneurysm may present to the orthopaedic team with back pain and femoral neuropathy. This demands a high index of suspicion as timely intervention saves lives.

We studied 45 patients with 46 fractures of the scaphoid who presented sequentially over a period of 21 months. MRI enabled us to relate the pattern of the fracture to the blood supply of the scaphoid. Serial MRI studies of the four main patterns showed that each followed a constant sequence during healing and failure to progress normally predicted nonunion.