nyimalay
Forum Elite
Topics: 9
Posts: 280
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With my little knowledge,
1. pain varies with position ( relieved with body incline forward)
2. lower limb and sphincter neurologic sign
3. ? history of muscle overuse, relieved by rest/at night
4. infection somewhere, HIV, at risk of TB, pain is constant, also occur at night
5. ??? septic features
6. metastasis: constant pain, age, h/o cancer or prostatism
7. age around 30, male, morning stiffness, restricted spine movement
8. sudden onset over background chronic pain, exaggerated by coughing, straight leg raising test
9. at risk of osteoporosis, trivial trauma, constant pain, not relieved by rest /at night
Please correct me if I m wrong.
Edited by nyimalay on 02/14/08 - 02:02 PM. Reason: correction
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| DrVirgo
Forum Hero
Topics: 1055
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I'll try to fill in what I know has been useful for me.
1.lumbar stenosis
-worse on extension, standing and leaning back
-better on flexion, sitting and leaning forward
(NOTE: Disc herniation is the opposite of above. so:
Disc Herniation:
-better on extension, standing and leaning back
-worse on flexion, sitting and leaning forward
3.lumbar muscle strain
-look for actual MUSCLE tenderness. they may say something about the paraspinal muscles being sore or tender. It may be seen after trauma.
4.osteomyelitis
-Look for fever. MRI for vertebral osteo. S. aureus.
6.metastasis
-look for history of cancer -breast, lung, or prostate are the most common.
7.ankylo spondiolitis
-Key word: sacroiliac joints or sacroilitis. HLA-B27 positive
9.vertebre #fracture
Could also happen due to mets if hx of cancer or also due to osteoporosis or a person on corticosteroids long term (look for hx of SLE, Temporal arteritis, or Cushings -as UW had these examples!)
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| RX 135
Forum Elite
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thanks...which are tender..
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| RX 135
Forum Elite
Topics: 21
Posts: 509
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on local examination findings??? thanks
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| nyimalay
Forum Elite
Topics: 9
Posts: 280
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I would say 3, 4, 9 . May be 6 too. What about 5?
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| farnsworth
Forum Newbie
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Posts: 165
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ad 5: the patient is usually in a real distress (fever, leukocytosis, elevated levels of CRP/IL-6/Procalcitonin), sometimes even septic.
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