Back pain Flashcards
Using reduced sieve, what is differential for back pain
V - spinal stenosis resulting in neurogenic claudication
Infx - osteomyelitis, TB
Trauma
Metabolic - Osteoporosis, renal osteodystrophy, Paget’s
Infm - spondyloarthropathy
Neoplastic - mets (sclerotic in prostate cancer), myeloma
Define Cauda equina
Red Flags in back pain
How manage?
Compression of spinal cord nerve roots below level at which the cord stops (L1/2) and nerves hang free. Can be due to prolapsed disc, inflammation, infection, malignancy etc.
Sciatica, Urinary retention, reduced anal tone, sacral anaesthesia, variable leg sensory and motor loss
IMMEDIATE neurosurgical referral. ? treat underlying cause if possible
What is progresisve cervical myelopathy?
What are its sequelae?
Signs and symptoms?
Myelopathy = pathology of the spinal cord.
PCM = cervical spondylosis i.e. pathology of spinal cord due to compression as a result of chronic disc degeneration, calcification and osteophyte formation
Leads to radiculopathy and myelopathy
Pain, worse on movement, poor balance, stiffness etc. Dermatome changes and sensation may occur…
