Dianosis and reasoning

Question 1

What are the diagnosis for case study 1 (Pelvis) and the reasoning behind them?

Answer 1

Main:
• SIJ dysfunction - location, cluster tests

Differentials:
• Spondylolysis - repetitive ext (gymnastics?), can be unilateral, often go missed and are picked up later (10 years back pain)
• non-specific LBP - location

Question 2

What are the diagnosis for case study 2 (Lumbar) and the reasoning behind them?

Answer 2

Main:
• L5 disc herniation - location, referred pain pattern, myotome weakness, age

Differential:
• Piriformis syndrome - buttock pain, tingling down leg, difficulty sitting for a long period of time
• Deep gluteal syndrome - buttock pain and some tingling/ numbness
• Spinal stenosis

Question 3

What are the diagnosis for case study 3 (Thoracic) and the reasoning behind them?

Answer 3

Main:
• Postural thoracic pain - location (around back and rib cage), worsens with stationary tasks

Differential:
• Thoracic spine pain & dysfunction - general thoracic pain
• Muscle strain, e.g. lats or rhomboids or traps

Question 4

What are the diagnosis for case study 4 (Cervical) and the reasoning behind them?

Answer 4

Main:
• Cervical spondylosis and rotator cuff strain - positive empty can, spurlings doesn’t reproduce Pb suggesting no radiculopathy cause, age, no trauma

Differentials:
• Upper fibres trapezius strain: location, limited time for healing
• Deep flexor weakness: CCFT, uses SCM, unable to hold