Spine

Question 1

Spine deformities + causes

Answer 1

? - ank spond - kyphosis + diminished lordosis

kyphosis - osteoporotic fracture, RA
scoliosis

Question 2

Spine - wasting - where + causes

Answer 2

paraspinal
gluteal

chronic back pain/immobility
RA

Question 3

Spine - abnormalities to feel for + causes

Answer 3

spinous processes - prominence, tenderness
SI joints - damage, sacroiliitis (ank spond)
paraspinal muscles - tenderness, spasm

Question 4

straight leg raise - what is positive, what does it suggest?

Answer 4

pain radiating posteriorly from 30-70 suggests disc herniation compressing L4, L5 or S1 roots

Question 5

femoral stretch test

Answer 5

pain radiating anteriorly suggests disc herniation compressing L2, L3 or L4 roots

Question 6

spine - joint below

Answer 6

hip

test internal rotation in flexion

Question 7

spine - neurovascular

Answer 7

power - all leg myotomes
reflexes - knee + ankle
sensation - all leg dermatomes
vascular - posterior tibial + dorsalis pedis

Question 8

spine - i would also

Answer 8

neuro lower limbs - cord compression
DRE if indicated - cauda equina
x-ray
MRI

Question 9

neurogenic claudication - cause, presentation

Answer 9

due to spinal stenosis (lumbosacral OA -> narrowing bony foramina -> nerve root impingement)
calf/buttock/thigh pain when walking that’s relieved bending over

Question 10

lumbar back pain - differentials

Answer 10

general - muscular, ank spond, prolapsed disc, OA, fracture [MAP OF]
serious - TB, osteomyelitis, myeloma, bone mets [TOMB]