10/9 Low Back Pain DSA - Joy 2017 (Completed) Flashcards
What is the difference between acute, sub-acute, and chronic back pain?
Acute pain less than 7 weeks
Sub-Acute pain 7- 12 weeks
Chronic pain > 12 weeks
Different viscerogenic back pain from vasculogenic?
Viscerogenic —> pain from organs
Vasculogenic —> pain from vascular structures
What are the viscerogenic causes for lower back pain?
Gastrointestinal:
—> IBD
—> Diverticulitis
—> Pancreatitis
What are the viscerogenic causes of lower back pain?
Reproductive Organs:
—> endometriosis
—> menstrual
—> prostatitis
What are the vasculogenic causes of lower back pain? How would you work these up?
Aortic aneurysm (US, CT or CT angiogram)
Ischemic spinal claudication (CT angiogram, MRI)
Define claudication?
Pain caused by too little blood flow
Define myelopathy?
Any neurologic deficit related to the spinal cord
What are the infectious causes of lower back pain?
Discitis
Herpes zoster
Osteomyelitis
What are the metabolic causes of lower back pain? How would you work these up?
Osteoporosis (DEXA scan)
Paget disease —> abnormally functioning bone cells (XR, bone scan)
What are primary tumors that may cause back pain?
Myeloma
Sarcoma
Osteoid osteoma
Neural tumor
What are secondary tumors that can cause lower back pain?
Metastatic tumors: —> prostate —> lung —> breast —> kidney
What are Rheumatologic causes of lower back pain?
Seronegetive Spondyloarthopathy
Fibromyalgia (diagnosis of exclusion)
Rheumatoid arthritis —> morning stiffness lasting greater than an hour
What are types of Seronegative Spondyloarthropathy?
Psoriatic arthritis
Ankylosing spondylitis —> bamboo spine (stiff)
IBD (enteropathic arthritis)
Reiter Syndrome
What are congenital causes of lower back pain?
Genetic malformations
A chondroblasts
Collagen disorders
What are genetic malformations that contribute to lower back pain?
Congenital scoliosis
Spina bifida
Meningocele
Meningomylocele