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DPT 763 - Differential Diagnosis > Head, Neck and Back > Flashcards

Head, Neck and Back Flashcards

1
Q

What are the major red flags for back pain?

A
  • back pain with hip or abdominal pain
  • bowel/bladder changes
  • previous history of cancer
  • night pain
  • no improvement after 4-6 weeks of PT
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2
Q

What is the key difference between mechanical and non-mechanical back pain?

A

Mechanical accounts for 97% of cases, while non-mechanical includes visceral causes (2%) and neoplasm/infection (1%).

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3
Q

What are the primary types of headaches?

A

Primary headaches include migraines and tension-type headaches.

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4
Q

What are secondary headaches?

A

Secondary headaches include cervicogenic and those caused by systemic conditions like cancer.

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5
Q

When should you refer a patient with headaches to a physician?

A

Refer if they have headaches with…

  • waking at night
  • personality changes
  • vision changes
  • seizures
  • history of HTN/tumor
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6
Q

What are the systemic origins of headaches?

A

Systemic causes include seizures, personality changes, vision changes, worse in the morning, etc.

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7
Q

What are the mechanical causes of cervical spine pain?

A
  • rheumatoid arthritis
  • cervical myelopathy
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8
Q

What are the red flags for cervical myelopathy?

A
  • (+) L’hermitte’s sign
  • gait changes
  • (+) Babinski
  • Hoffmann’s test
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9
Q

What are the vasculogenic causes of cervical spine pain?

A

Cardiac and vascular issues.

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10
Q

How do you differentiate cervicogenic from systemic cervical pain?

A

Cervicogenic pain changes with activity and rest; systemic causes may not.

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11
Q

What are the systemic causes of thoracic spine pain?

A

Cardiac (MI, aneurysm)

GI (peptic ulcers).

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12
Q

What are the associated signs of systemic thoracic spine pain?

A

Constitutional symptoms like fever, pallor, high/low BP.

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13
Q

What are key questions for identifying inflammatory back pain?

A

Does pain alternate sides? Morning stiffness >30 mins? Does rest relieve pain?

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14
Q

What are the systemic causes of lumbosacral pain?

A

Inflammatory causes, systemic illness, and visceral pathology.

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15
Q

What are neurogenic causes of pain?

A

Radicular pain, sciatica, other neuropathies.

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16
Q

What are vasculogenic causes of pain?

A

AAA, vascular headaches, demand > supply issues.

17
Q

What are the red flags for oncologic back pain?

A

History of cancer, age >50, unexplained weight loss, failure to improve after one month of treatment.

18
Q

What are the clinical signs of oncologic back pain?

A

Pain with weight-bearing, midline tenderness, weakness, skin temperature differences.

19
Q

What are the gynecologic causes of back pain?

A

Endometriosis, ovarian cysts, cyclic pain, fluctuating hormone levels.

20
Q

What is the clinical presentation of endometriosis?

A

Back, pelvic, hip, or sacral pain, cyclic in nature, related to fluctuating hormone levels.

21
Q

What are the risk factors for infectious causes of back pain?

A

Fever, immunosuppression, IV drug use, HIV.

22
Q

What is vertebral osteomyelitis?

A

An infection of the vertebrae, often caused by MRSA, with risk factors including diabetes, IV drug use, or corticosteroids.

23
Q

What are the signs and symptoms of cancer-related back pain?

A

Unexplained weight loss, history of cancer, constant/intense pain worse with WB, red flags for metastatic disease.

24
Q

How do you differentiate cervicogenic from migraine headaches?

A

Cervicogenic: Pain varies with activity, neck stiffness. Migraine: Aura, photophobia, unilateral throbbing pain.

25
Q

What are the signs of vascular vs neurogenic pain?

A

Vascular: Throbbing, worsens with activity. Neurogenic: Sharp, shooting, follows nerve root patterns.

26
Q

What are the signs of psychogenic pain?

A

Cogwheel motion during muscle testing, amplified pain perception, reflexes inconsistent with complaints.

27
Q

What are the signs of rheumatoid arthritis-related cervical spine pain?

A

AA subluxation, C2 nerve involvement, risk of myelopathy with long-standing RA.

28
Q

What are viscerogenic causes of back pain?

A

GI (gallbladder, pancreas), renal (kidney stones), reproductive, pulmonary causes; shared innervation leads to referred pain.

29
Q

What are the signs of peptic ulcer-related thoracic pain?

A

Referred pain to T6-T10, worse with NSAID use, symptoms affected by food intake.

30
Q

What are the signs of gallbladder-related pain?

A

Referred pain at the 10th rib, onset after fatty meals, associated GI symptoms.

31
Q

What are the signs of ovarian cysts?

A

Often asymptomatic until large, cyclical pain patterns, fluctuating with hormone levels.

32
Q

What is the clinical presentation of vertebral osteomyelitis?

A

Gradual onset of severe pain over weeks, MRSA infection common, risk factors include diabetes, surgery, IV drug use.

DPT 763 - Differential Diagnosis (15 decks)

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