Back Pain Flashcards
Lumbar disc herniation – pain must be exacerbated by these activities to be a herniated disc?
Coughing, sneezing, defecating
Lumbar disc herniation – spinal level? Description of pain?
L4-L5 or L5-S1
- They taking pain produced by pressure on anterior spinal ligament
- Later, sudden onset of neurogenic pain (Like electrical shock shooting down leg) precipitated by forced movement
Lumbar disc herniation – physical exam findings? Confirm diagnosis with? Management? When surgery?
Positive straight leg raising test
MRI
- Three weeks of bedrest
- Nerve blocks for pain
- Surgery if neurological deficits are progressing or cauda equina syndrome
Signs if Cauda equina syndrome? Surgery when?
Distended bladder, flaccid rectal sphincter, perineal saddle anesthesia
Immediate surgery
Ankylosing spondylitis – demographic? Pain worse when?
30-40 year old men
Pain worse at rest, improved with activity
Elderly patient with progressive back pain that is worse at night and unrelieved by rest or positional changes – Suspected diagnosis? Diagnostic tests?
Metastatic malignancy; x-ray or MRI