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We report a unique case of a 42-year-old patient with an acute inflammatory low back pain with bilateral radiculopathy associated with weight loss and abdominal pain, revealing the disintegration of a lead bullet along the epidural space and the S1 nerve root complicated by lead poisoning. Because of the high blood lead level of intoxication (&gt;10 times over the usual lead levels) and the failure of repeated lead chelator cycles, a surgical treatment to remove bullet fragments was performed. It resulted in a significant decrease of pain and lead intoxication.<\/jats:p>","DOI":"10.1136\/rmdopen-2023-003119","type":"journal-article","created":{"date-parts":[[2023,12,8]],"date-time":"2023-12-08T00:20:21Z","timestamp":1701994821000},"page":"e003119","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Inflammatory low back pain with radiculopathy revealing epidural disintegration of a bullet complicated by lead poisoning"],"prefix":"10.1136","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-8415-7193","authenticated-orcid":false,"given":"Ariane","family":"Do","sequence":"first","affiliation":[{"name":"Department of Rheumatology, Hospital Saint-Antoine, Paris, France"},{"name":"Sorbonne University, Paris, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lorenzo","family":"Garzelli","sequence":"additional","affiliation":[{"name":"Department of Radiology, Hospital Saint-Antoine, 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