Back pain

Question 1

red flags cauda equina

Answer 1

saddle paraesthesia
bladder dysfunction
faecal incontinence
perinanal/perineal sensory loss - can you feel when you wipe?
lax anal sphincter
neuro deficit lower extremeteis

Question 2

spinal fracture pain red flag

Answer 2

sudden onset, severe central pain

relieved lying down

Question 3

spinal cancer red flags (mets or myeloma) - what is the pain like?

Answer 3

remains when lying down

aching night time pain that disturbs sleep

Question 4

worrying age to start getting back pain and it could be ?cancer

Answer 4

> 50 year old

<20 year old

Question 5

inflammatory diseases that affect the spine

Answer 5

ank spond
psoriatic arthritis
reactive arthritis
enterpathic arthritis (IBD)

Question 6

infective cause of back pain to never forget

Answer 6

TB!!!! never forget

Question 7

x-ray findings in bone mets of lung thyroid and kidney vs prostate finding

Answer 7

lung, thyroid and kidney = osteolytic prostate = sclerotic (breast can be both)

prostate helps with Semen

Question 8

causes of lower back pain

Answer 8

mechanical
OA of spine
prolapsed disc
crush fracture
rheumatoid
discitis

Question 9

when is trendelenburg sign positive

Answer 9

hip abductors week (L5)

let is raised -> pelvis tilts towards this side indicating contralateral hip abductor weakness

Question 10

most common place for disc prolapse

Answer 10

l4-l5, l5-s1

Question 11

clinical features of spinal stenosis

Answer 11

pain in back, buttock, calves and feet
stiffening of spine
worse on spine extension
relieved by rest and spine flexion

(degenerative narrowing of spinal canal causing nerve root compression)

Question 12

who is discitis more common in

Answer 12

IVDU

immunocompromised

Question 13

rx discitis

Answer 13

IV abx 6 week