Low Back Pain

Question 1

Discitis

Answer 1

Recent skin infection, UTI, or IVDA. Also consider immunocompromised

Pain at rest/night

Localized

Question 2

Herpes Zoster

Answer 2

Pain precedes rash

Question 3

Osteomyelitis

Answer 3

Pretty much the same as discitis

Question 4

Osteoporosis

Answer 4

Chronic pain, may be acute with compression fracture.

Work up: DEXA scan, +/- XR with

Question 5

Pagets disease

Answer 5

Bone cells don’t function properly. Get a bone scan which shows uptake of the radioactive substance in the affected areas

Question 6

Primary tumors

Answer 6

• Myeloma
• Sarcoma
• Osteoid osteoma

Question 7

Workup for primary tumors

Answer 7

Start with x-ray, then may need bloodwork, CT, MRI

Question 8

Types of neural tumors

Answer 8

• Neurofibroma
• Schwannoma
• Meningioma

Question 9

Secondary tumor

Answer 9

aka “metastatic”

Multiple lesions seen

May start insidiously, chronic

Question 10

Locations of secondary tumors

Answer 10

Prostate, lung, breast, kidney

Question 11

Seronegative Spondyloarthropathy

Answer 11

Psoriatic arthritis
Anklyosing spondylitis
Inflammatory bowel disease
Reiter syndrome

Question 12

psoriatic arthritis

Answer 12

“pencil in cup deformities”

Question 13

ankylosing spondylitis

Answer 13

“bamboo spine” due to calcification

Question 14

Reiter syndrome

Answer 14

calcification of the back, just more lateral on the spine

Question 15

seronegative spondyloarthropathy workup

Answer 15

HLA-B27 and XR

Question 16

Fibromyalgia dx

Answer 16

11 of 18 tenderpoints

Question 17

Rheumatoid arthritis symptoms

Answer 17

morning stiffness >1 hour, fatigue, joint arthritis

Question 18

Achondroplasia

Answer 18

Pain usually due to spinal stenosis or increased lordosis

Question 19

Workup for achondroplasia

Answer 19

maternal ultrasound

Question 20

workup for marfan and ehlers danlos

Answer 20

History and PE

Question 21

somatoform disorder

Answer 21

psych disorder where you can’t be explained by physical findings