Diagnostic Imaging & Formulating Osteopathic Diagnosis (Lumbar Spine)

Question 1

Undiagnosed serious pathology in patients presenting with acute LBP in primary care setting is how common?

Answer 1

Very rare

Question 2

Routine or immediate lumbar spine imaging for LBP without indication of serious underlying conditions does what?

Answer 2

• Does not affect management
• Does not improve clinical outcomes
• Is associated with radiation exposure & increased expenses

Question 3

X-ray, CT or MRI will give information about

Answer 3

Presence or absence of tissue damage

Question 4

Red flags for acute LBP

Answer 4

• Age of onset <20 years or >55 years
• Recent history of violent trauma
• Constant progressive, non mechanical pain (no relief with bed rest)
• Thoracic pain
• Past medical history of malignant tumor
• Prolonged use of corticosteroids
• Drug abuse, immunosuppression, HIV
• Systemically unwell
• Unexplained weight loss
• Widespread neurological symptoms (including cauda equina syndrome)
• Structural deformity
• Fever

Question 5

Process of reading x-rays

Answer 5

A - Adequacy & all views present
A - Artifacts
A - Alignment
B - Bones
C - Cartilage
S - Soft tissues

Question 6

Sacral base angle should be?

Answer 6

35-45 degrees