| Author | 3 Posts |
dr_jojo
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can any one one give the clues for the following causes of back pain
A
) Herniated disc
B
) Lumbar spinal stenosis
C
) Metastatic cancer
D
) Muscle strain
E
) Osteoporotic compression fracture
F
) Sacroiliitis
G
) Spinal epidural abscess
H
) Spondylolisthesis
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| dr_jojo
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37. A previously healthy 32-year-old plumber comes to the physician because of a 3-week history of constant, dull, low back pain that does not radiate to the extremities. The pain began after he unloaded heavy equipment from his van. It increases with activity and is temporarily relieved by bed rest and ibuprofen. Examination shows tenderness to palpation over the lumbar paraspinal region bilaterally. The pain increases with forward or lateral movements of the spine. Muscle strength and sensation are intact in the lower extremities. Bilateral straight-leg raising to 80 degrees does not increase the pain. Deep tendon reflexes are 2+ bilaterally. Babinski's sign is absent bilaterally.
DX
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| docnikki
Forum Guru
Topics: 93
Posts: 680
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according to me answer is D.
A ) Herniated disc --> straight leg and crossed leg raise shd be postive, pain radiates below the butts even below knee at times
B ) Lumbar spinal stenosis --> should be relieved by flexion and aggravated by lordosis
C ) Metastatic cancer --> pain shd be ocurring at rest also..and the pt was previously normal too so this one is out
D ) Muscle strain --> paraspinal tenderness..normal muscle strenth and other p/e findings..i go with this one
E ) Osteoporotic compression fracture --> pain shd occur at rest also.
F ) Sacroiliitis --> pain shd get better with activity..
G ) Spinal epidural abscess -->symp of large or rapidly evoloving neurological deficits..b/l leg weakness, saddle anesthesia bowel bladder incontinence impotence..all this can occur in cauda quina synd too..these are medical emmergency
H ) Spondylolisthesis -- step off noted between spinous processes..what more can be added to this one regarding symptoms..plz anyone add..Im not sure.
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