Back Pain Flashcards
what are athletes who do have repetitive microtraumas due to certain movements at risk for?
Spondylolysis
What is spondylolysis?
Stress fracture of vertebral pars articularis
What might bilateral spondylolysis lead to?
Spondylolysthesis
What is spondylolysthesis?
forward slippage of cephalic vertebrae relative to the caudal vertebrae
What is scheuermann kyphosis? Where does it typically occur?
anterior wedging of ≥5 degrees in three consecutive vertebrae, typically occurs in the lower thoracic region
When should discitis be suspected?
common in children younger than five, has an insidious onset, and often presents with nonspecific symptoms such as irritability, crying at night, and refusing to sit
What is the classic presentation of spinal epidural abcess?
fever, spinal pain, and neurologic deficits
What is the most common tumour that presents with back pain?
Osteoid osteoma
When is pain from osteoid osteoma most prominent?
Night
What gynecological abnormality can lead to back pain in a teenage female?
Imperforate hymen
List back pain red flags on history and physical
History Direct or repetitive trauma Constant pain or night-time pain Pain that improves with movement Young age Fever Incontinence Weakness Numbness Intravenous drug use Chronic steroid use History of tuberculosis exposure Physical Weakness Anal sphincter weakness Saddle anesthesia Abnormal deep tendon reflexes Spinal tenderness
What is a physical finding of spondylolysis?
Excessive lumbar lordosis
Pain with hyperextension of the back
What is the physical exam finding for Scheuermann kyphosis?
fixed thoracic or lumbar kyphosis unaffected by patient position which is best observed from the side during trunk flexion
In what position/movement will patients with discitis experience pain?
Back flexion
What does a positive straight leg raise suggest?
radiculopathy, possibly secondary to disc herniation or spondylolisthesi
