Back Pain

Front 1

The rare, but emergent diagnoses must be excluded before assuming mechanical back pain x 6

Back 1

aortic dissection
abdominal aortic aneurysm
cauda equina syndrome
epidural abscess
osteomyelitis
tumor

Front 2

LBP History- red flags x7

Back 2

h/o steroid use,
h/o cancer,
unexplained fever > 38 degrees C,
IV drug use, immunocompromising illness,
H/o pain that is worse at rest,
new onset back pain over 70 yo
wt. loss - unexplained

Front 3

physical red flags:
vascular x 4
neuro x 3

Back 3

Vascular
-unequal pulse pressures, -hypotension,
-pulsatile abdominal mass,
-lower extremity vascular compromise, etc.
neurological exam
-loss of sphincter tone,
-lower extremity weakness, -incontinence.

Front 4

cauda equina syndrome:
sxs x 4
causes x 3

Back 4

<1% of herniated discs
-bilateral leg pain and weakness, -urinary retention with overflow incontinence,
- fecal incontinence or decreased rectal tone, and
-"saddle anesthesia";
usually due to a large central herniated disk, and less often to tumor or infection.

Front 5

Which is more common - aortic dissection or AAA?

Back 5

Aortic dissection is two to three times more common than Abdominal aortic aneurysm

Front 6

Indications for L spine x-rays in low back pain

Back 6

trauma
neurologic deficits,
< 4 weeks
h/o cancer,
age over 50

Front 7

Spinal epidural abscess:
risk factors x 4
study of choice ?
causative organism in 70%?
initial focus of infection?

Back 7

- compromised immune systems such as those with diabetes, renal failure, cancer, or alcoholism.
-MRI is the study of choice.
-causative organism is Staphylococcus aureus
- it begins as a localized infection in the disk.

Front 8

What syndrome presents with: acute back pain B leg weakness
B LE sensory defects B/B dysfunction ?
What type of diseases is it associated with? examples x 6

Back 8

transverse myelitis

often associated with autoimmune diseases: type 1 diabetes
Lyme disease Epstein-Barr virus.
multiple sclerosis, lupus (SLE),
sarcoidosis