back pain d 1 Flashcards
back pain +
Clinical Clues=
Urinary retention+Saddle anesthesia (asymetric or not) +
leg weakness +sciatica + decr. Anal sphincter tone/
think =>
Cauda equina syndrome
back pain + Clinical Clues=
Fever +- chills
Recent skin or UTI/
Immunosuppression
Injection drug use/
think =>
Infection
back pain + Clinical Clues=
Ca hx ( especially active ca)
Unexplained weight loss (>10lbs over 6 mo)
50yo>
Duration of pain > 1 month
/think =>
Malignancy (mets!!)
back pain + Clinical Clues=
70 +yo Female sex/
Corticosteroid use
Hx of osteoporosis & /or
significant Trauma/
prior fracture/
think =>
osteoporotic Compression fracture
back pain + Clinical Clues=
Sciatica
Abnl neuro exam
for ex = straight leg raise test /
think =>
Lumbar radiculopathy/herniated disk
back pain/ mechanical back pain/
important tests
none!
Resolution in 4-6 wks
back pain/ herniated disks/
important tests
CT
or MRI
back pain/Malignancy /
important tests
Spine radiograph MRI
back pain/infection /
important imaging tests
MRI
back pain/Cauda equina syndrome /
important tests
MRI
back pain/ Compression fracture/
important tests
spine radio graphy+ MRI
back pain+ No neurologic or systemic symptoms=>
think
Nonspecific mechanical back pain
back pain + clinical clues =
Wide-based gait
Neurogenic claudication
Age > 65
Improvement with sitting/bending forward /
think=>
Spinal stenosis
back pain /Spinal stenosis/
important tests
MRI
back pain + clinical clues =
Vascular risk factors;
leg pain with walking/
think=>
Peripheral arterial disease
