Could this atypical image be an unexpected combination? A visual vignette.

ABSTRACT:

Background

We report the case of a patient who underwent transforaminal epidural steroid injection (TFESI), and a combination of intradural contrast media spread and dural pulsation during the procedure.

Objective

We aimed to raise awareness of the importance of recognising atypical images in interventional pain procedures.

Methods

A 67-year-old woman presented with low back and right leg pain due to spinal stenosis. We performed right L3 TFESI with a Quincke spinal needle under the guidance of C-arm fluoroscopy. The needle placement on imaging consistent with the epidural region, but contrast distribution suggested subdural spread. When we administered contrast material again, the contrast extended and widened a little more in the cranio-caudal direction in the same

SUBMITTER: Isik R 

PROVIDER: S-EPMC12309264 | biostudies-literature | 2025 Sep

REPOSITORIES: biostudies-literature