New Clinical MSK Flashcards
What is the most common kind of back pain?
Low Back Pain
70% lifetime prevalence.
What are the risk factors for low back pain?
Weight
Genetics
Sedentary
Occupational Risk
What are red flags of back pain?
Unexplained Fever Unexplained Weight loss Worse in supine Bowel or bladder incontinence Trauma Progressive neurological deficit Minor Trauma over 50
What are the most common places of radicular back symptoms?
Upper limb at C7 Nerve root
Lower limb at L5 or S1 root
What is Spondylosis
Disc Degeneration
Formation of osteophytes.
Facet joint arthropathy
Lowers amount of space for nerves
What is Lumbar Spinal Stenosis?
Starts with disc degeneration and moves on to articular process fusions.
Can do laminectomy, not always good.
They will lean forward because it feels better (on a shopping cart), feel better sitting.
What is spondylolysis, and where is the most common place?
What test can be used to find it?
Non-displaced stress fracture of pars interarticularis.
Overuse injury of hyperextension and or rotation.
L5 is most common level.
Stork test. One hip and knee flexed with hyperextension of back.
Spondylitis
Inflammatory arthritis which typically starts at the SI joint and ascends up the spine (as in Ankylosing spondylitis)
Spondylolisthesis
Bilateral fractures of the pars interarticularis leads to instability of the vertebral column causing one vertebrae to slide on the adjacent vertebra.
What is the straight leg raise?
Used to find sciatic nerve compression.
At 30-60 deg with knee extended the pain will radiate down the leg.
Over 70 deg pain is more muscle pain.
What is the lasegue test seated?
Have patient raise leg while seated with knee extended
To avoid pain, pt will lean back and use arms for support as leg gets higher.
What is spurring maneuver?
Aggressive cervical compression test to look for pain on concave or convex side. Concave pain is nerve root, convex side is muscle strain.
What are neck and back pain classification?
When can you image the pain
Acute less than 3 months,
Subacute 4-12 weeks
Over three months (12 weeks) is chronic.
Can only image usually after 4-6 weeks of no change.
TUNA FISH
Red Flags of back pain
Trauma Unexplained Weightloss Neurological Symptoms Age over 50 Fever IV drug use Steroid Use History of Cancer
What are the Hard Stops of Back Pain
Cauda Equina Syndrome: Time is tissue
-Saddle anesthesia, urinary and bowel incontinence, lose reflexes
