Week1

Question 1

Referrals- Emergent

Answer 1

Cauda equina 
Infection 
Myopathy 
Fx 
Stroke
Myocardial infarction

Question 2

Additional questions to ask?

Concern about spine infection

Answer 2

Fever?

Recently on antibiotics or other meds for infection?

Dx with immunosuppressive disorder?

Does pain ease with rest in comfortable position?

Question 3

Primary OA of cervical spine usually involves?

Answer 3

C5-6

C6-7

Question 4

Monoarticular

4 common dx

Answer 4

OA
Gout
Psoriatic arthritis
Septic arthritis

Question 5

Serious conditions in lumbar region?

Red flag

Answer 5

1. Tumor
2. Spinal infection
3. Vertebral fx
4. Cauda equina

Question 6

Additional questions to ask?

Concern about spine fx.

Answer 6

Recently have major trauma, car crash, fall from height?

Ever dx with osteoporosis or other disorders that could cause “weak bones?”
(Includes: hyperparathyroid, renal failure, chronic GI disorders, and long-term use of corticosteroids)

Question 7

Visceral pain often described as

Answer 7

Aching 
Squeezing 
Gnawing 
Burning 
Cramping

Question 8

RA of cervical spine usually involves?

Answer 8

Entire cervical spine

vs OA C5-6, C6-7

Question 9

Referrals- urgent

Answer 9

Fx

Progressive neurological deficits

Question 10

LBP
Additional questions to ask?
Colon cancer concern

Answer 10

Older than 50

Hx of colon ca in immediate family (1st degree relative)

Bowel disturbance (rectal bleed or black stools)

Unexplained weight loss

Back or pelvic pain unchanged by movement or positions

Question 11

Additional questions to ask?

Concern Cauda Equina

Answer 11

Recent difficulty with retaining urine or starting urine flow?

Need to urinate more frequently?

Saddle paresthesia (numbness on bottom like a bike seat)?

Legs weak waking or climbing stairs?

Question 12

LBP cancer red flags

Answer 12

50 yo or older
Hx of ca
Unexplained weight loss
Failure to improve with conservative care

Question 13

What is medical screening?

Answer 13

Process of evaluating pt exam data for purpose of deciding whether pt referral is warranted

NOT synonymous with differential diagnosis

Question 14

Vascular disorder pain often described as?

Answer 14

Throbbing
Pounding
Pulsating

Question 15

Poliarticular

6 Common dx

Answer 15

1. RA (usually symmetrical)
2. Juvenile RA (May be asymmetric)
3. Psoriatic arthritis
4. Systemic lupus erithematosus (usually asymmetric)
5. Ankylosis spondylitis (often asymmetric)
6. Reactive arthritis (often asymmetric)

Question 16

Referrals- general

Answer 16

Second opinions

Follow up appointments

Question 17

Additional Questions to ask?

Concern for spine tumor

Answer 17

hx of cancer?

Lost weight without trying?

Question 18

2 joint conditions that usually start at MTP

Answer 18

Gout

Reiter’s syndrome

Question 19

8 Conditions associated to non-joint limb pain (referral needed)

Answer 19

1. Hypothyroidism
2. Lyme disease
3. Polymyalgia rheumatica
4. Statin-related myopathies or myalgias
5. Vascular and neurogenic claudication
6. Stress fx (tibial)
7. DVT
8. Compartment syndrome

Question 20

OA rarely involves which joints?

Answer 20

Elbow
Forearm
Cranio-mandibular

Question 21

Neurologic disorder pain frequently described as

Answer 21

Sharp
Lancing
Burning
Shocking

Question 22

Night pain questions

Answer 22

How many nights per week?

Is there a consistent time you wake up?

How does intensity of night pain compare with pain during day?

What do you have to do to fall back asleep?