Spinal Conditions

Question 1

Builder presents with pain in lumbar region that is worse with coughing, it has occured for the last 2 months. It occured all of a sudden when he was lifting a fridge. Diagnosis? Treatment?

Answer 1

Acute disc tear/ discogenic back pain

Analgesia and physio

Question 2

Man presents with shooting pains down the right side of his buttock and radiating down his right leg. He has finds it difficult to stand from sitting as he feels there is extra strain on the right thigh. Diagnosis?

Answer 2

Sciatica due to myotomal and dermatomal distribution. As sciatic nerve supplies the posterior thigh compartment responsible for extension of the thigh hence difficult stand from sit

Question 3

Man of 65 presents with cramping burning pain in his legs when walking, its worse down hill and there isn’t a set distance that brings on the pain. He is overweight. You do his peripheral pules which are preserved. Diagnosis

Answer 3

Spinal stenosis- cauda equina nerve roots compressed

Likely due to overweight causing bulging discs and worse downhill from extension of spine

Question 4

Man presents with inability to control defeacation, urination, he has bilateral leg pain with paraesthesia and numbness around his butt. Diagnosis? Investigations?

Answer 4

Cauda equina syndrome
Due to prolapse of a central disc compressing all nerve roots of the cauda equina.

PR EXAM AND URGENT MRI

Question 5

What does tinels test diagnose?

Answer 5

Carpal tunnel syndrome

Involves percussion over median nerve to reporduce parathesiae

Question 6

What is phalens test? Waht for?

Answer 6

Hyperflexion of the wrists to decrease the space in carpal tunnel

Carpal tunnel syndrome

Question 7

Women with known rheumatoid arthritis presents with parathesiae in thumb, middle and index finger. Its worse at night, she finds herself dropping glasses as she cant get a strong hold of them. Diagnosis? Treatment?

Answer 7

Carpal tunnel syndrome

More common in women, relation with RA, weakness of thumb as supplied by median nerve

Wrist splints at night to preent flexion, corticoid injections

Question 8

Women is froments test positive and have parathesiae in the pinky and ring finger of right hand. Likely diagnosis?

Answer 8

Cubital tunnel syndrome

• compression of the ulnar nerve taht supplies the pinky and ring finger