Back Pain (Rheum) Flashcards
Low back pain with paraspinal tenderness + normal neuro exam
Mechanical
- Muscle strain
- Disc degeneration
Low back pain w/ radiation below knee, +straight leg raise test, neurologic deficits
Radiculopathy
(Herniated disc)
Low back pain w/ pseudoclaudication, relieved by leaning forward
Spinal stenosis
Low back pain worse w/ rest, improved with activity, with pain in the SI joints
Inflammatory
(Spondyloarthropathies; PAIR):
- Ankylosing spondylitis
- Psoriatic arthritis
- Reactive arthritis
- Inflammatory Bowel Disease
Low back pain, worsens w/ activity, relieved with rest
Lumbar osteoarthritis
Low back pain >50yo, worse at night, not relieved with rest
Metastatic cancer
(Spinal mets)
Low back pain + IVDU or recent infection, fever, focal spine tenderness
Infectious
- Osteomyelitis
- Discitis
Low back pain + midline tenderness
Vertebral fracture
Low back pain that increases w/ standing, walking, or lying on back
Vertebral Compression Fracture
(usually 2/2 osteoporosis)
Low back pain that is posture-dependent & persistent when standing
Lumbar spinal stenosis
(Neurogenic claudication)
Low back pain that is exertional and goes away within ~30 seconds of sitting
Vascular claudication
(PVD)
Low back pain relieved by flexion of the spine
Lumbar spinal stenosis
- Relieved w/ sitting & walking uphill (spinal flexion)
Evaluation for peripheral vascular disease that presents with vascular claudication
ABI
(Ankle-Brachial Index)
Gene and age group of ankylosing spondylitis (AS)
- HLA-B27
- 15-30yo young males
Enthesitis (inflammation/tenderness at tendon insertion sites)
Spondyloarthropathies (PAIR):
- Psoriatic arthritis
- Ankylosing spondylitis
- Inflammatory Bowel Disease
- Reactive arthritis