OSCE

Question 1

Differentials for back pain

Answer 1

Vascular - spinal epidural hematoma, spinal cord infarction
Infectious - spinal epidural abscess, discitis, vertebral osteomyelitis, Pott disease
Neoplastic - spinal mets, referred pain
Degenerative - disc disease, spondylosis, stenosis, spondylolistheis, compression fractures
Iatrogenic - surgical site infection, nerveinjury, steroid osteoporosis, nerve block, spinal manipulation
Congenital - scolosis, spina bifida, marfan
AI/ Inflammatory - ank spond, psoriatic arthritis, reactive arthritis
Traumatic - vertebral fractures, disc prolapse, whiplash, SC injury
Endocrine/ metabolic - osteoporosis, pagets, hyperparathyroidism, rickets

Question 2

Red flags back pain

Answer 2

Trauma
Unexplained weight loss
Neuro sx
Age >50
Fever
IVDU
Steroids
Hx of ca
Not relived by rest
Worse at night
Progressive/ persistent despite >4 weeks of conservative mng

Question 3

Yellow flags for back pain

Answer 3

Avoiding activity
Low mood, social w/d
Belief in passive treatment
Belief that back pain is not disabling

Question 4

Urgent spinal causes of acute back pain

Answer 4

Compressive spinal emergencies
Vertebral fractures
SPinal infections
Spinal epidural hematoma causing cord compression