{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,10]],"date-time":"2026-08-10T02:28:08Z","timestamp":1786328888457,"version":"build-2736575974"},"reference-count":40,"publisher":"MDPI AG","issue":"16","license":[{"start":{"date-parts":[[2026,8,9]],"date-time":"2026-08-09T00:00:00Z","timestamp":1786233600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Low back pain (LBP) is one of the most common causes of medical consultation worldwide and is typically attributed to degenerative spinal disorders. However, a subset of patients presents with LBP related to extra-spinal conditions, including disorders of the lumbar plexus. These conditions are often underrecognized and may mimic lumbar radiculopathy, leading to delayed diagnosis or inappropriate management. The lumbar plexus, formed by the anterior rami of L1\u2013L4 nerve roots, lies deep within the psoas muscle and can be affected by a wide range of pathological processes, including traumatic, compressive, inflammatory, infectious, and neoplastic conditions. A targeted literature search of the PubMed\/MEDLINE database was performed to identify relevant English-language articles on lumbar plexus disorders, their imaging features, and diagnostic strategies published from inception to June 2026; representative imaging examples were selected from the co-authors\u2019 clinical archives. The review summarizes the relevant anatomy, clinical presentation, and key imaging features of the most common plexus pathologies, including retroperitoneal tumors, psoas hematomas, inflammatory plexopathies, and iatrogenic injuries. Advances in imaging techniques, particularly magnetic resonance imaging (MRI) and magnetic resonance neurography (MRN), have significantly improved the ability to visualize the lumbar plexus and detect pathological changes involving peripheral nerves and surrounding structures. Additionally, a practical diagnostic imaging approach is proposed to assist radiologists and clinicians in recognizing lumbar plexus involvement in patients with atypical low back pain.<\/jats:p>","DOI":"10.3390\/diagnostics16162509","type":"journal-article","created":{"date-parts":[[2026,8,10]],"date-time":"2026-08-10T01:20:03Z","timestamp":1786324803000},"page":"2509","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Lumbar Plexus Disorders Presenting as Low Back Pain: A Narrative Review of a Practical Diagnostic Imaging Approach"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1444-2585","authenticated-orcid":false,"given":"Federico","family":"Bruno","sequence":"first","affiliation":[{"name":"Department of Biotechnological and Applied Clinical Sciences, University of L\u2019Aquila, 67100 L\u2019Aquila, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5093-8692","authenticated-orcid":false,"given":"Raffaele","family":"Natella","sequence":"additional","affiliation":[{"name":"Department of Medicine and Health Science \u201cV. Tiberio\u201d, University of Molise, 84100 Campobasso, Italy"},{"name":"Fondazione Trotula de Ruggiero, 84121 Salerno, Italy"},{"name":"Biomedical Research Centre, Gruppo Forte, 84124 Salerno, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giorgio","family":"Reverchon","sequence":"additional","affiliation":[{"name":"Department of Radiology, \u201cSt. Giuseppe Moscati\u201d Hospital of National Relevance and High Specialty, 83100 Avellino, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giulia","family":"Pacella","sequence":"additional","affiliation":[{"name":"Department of Medicine and Health Science \u201cV. Tiberio\u201d, University of Molise, 84100 Campobasso, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-4024-1309","authenticated-orcid":false,"given":"Michela","family":"Bruno","sequence":"additional","affiliation":[{"name":"Department of Medicine and Health Science \u201cV. Tiberio\u201d, University of Molise, 84100 Campobasso, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mario","family":"Brunese","sequence":"additional","affiliation":[{"name":"Department of Precision Medicine, University of Campania \u201cL.Vanvitelli\u201d, 80138 Napoli, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giulio","family":"Lombardi","sequence":"additional","affiliation":[{"name":"Department of Radiology, \u201cSt. Giuseppe Moscati\u201d Hospital of National Relevance and High Specialty, 83100 Avellino, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3584-2692","authenticated-orcid":false,"given":"Corrado","family":"Caiazzo","sequence":"additional","affiliation":[{"name":"Department of Medicine and Health Science \u201cV. Tiberio\u201d, University of Molise, 84100 Campobasso, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4867-5344","authenticated-orcid":false,"given":"Marcello","family":"Zappia","sequence":"additional","affiliation":[{"name":"Department of Medicine and Health Science \u201cV. Tiberio\u201d, University of Molise, 84100 Campobasso, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,8,9]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"e316","DOI":"10.1016\/S2665-9913(23)00098-X","article-title":"Global, regional, and national burden of low back pain, 1990\u20132020, its attributable risk factors, and projections to 2050: A systematic analysis of the Global Burden of Disease Study 2021","volume":"5","author":"Ferreira","year":"2023","journal-title":"Lancet Rheumatol."},{"key":"ref_2","first-page":"e240099","article-title":"MR Neurography of the Lumbosacral Plexus: Technique and Disease Patterns","volume":"45","author":"Pitman","year":"2025","journal-title":"Radiogr. Rev. Publ. Radiol. Soc. N. Am. 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