The Journal of Bone and Joint Surgery

Image Quiz
Sciatica Following a Fall¹
A thirty-two-year-old man who had a history of alcohol abuse fell down a flight of stairs while intoxicated and was not found until the following day. The injuries included a mild closed head injury, several fractures of the ribs, and a contusion of the right thigh and the left buttock. A few days later, he noted increasing pain that radiated from the left gluteal region to the posterior portions of the thigh and calf. Three weeks after the injury, he observed paresthesias and decreased sensation on the lateral border of the left foot as well as weakness in the left ankle. He did not have pain or spasm in the back. Symptoms did not resolve with time. Nine weeks after the injury, computerized axial tomography and magnetic resonance imaging studies were performed.
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Fig. 1 Computerized axial tomograph of the pelvis.	Fig. 2 T1-weighted magnetic resonance image.

What is the diagnosis?