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10 Cards in this Set
- Front
- Back
Key History -
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Location
quality radiation severity (intensity) context - moving furniture bending/twisting trauma timing - disturbs sleep associated Sxs - constitutional incontinence exacerbating and alleviating factors h/o cancer recurrent UTIs diabetes renal stones IV drug use smoking |
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Key PE -
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VS
neuro exam - esp. L4-S1 nerve roots back palpation and range of motion hip exam consider rectal exam |
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45 y/o F
presents with low back pain that radiates to the lateral aspect of her left foot. Straight leg raising is positive. Pt. is unable to tiptoe. What is Differential? |
Disk herniationLumbar muscle strain
Tumor in the vertebral canal |
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45 y/o F
presents with low back pain that radiates to the lateral aspect of her left foot. Straight leg raising is positive. Pt. is unable to tiptoe. What is Workup? |
XR - L-spine
MRI - L-spine |
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45 y/o F
presents with low back pain that started after she cleaned her house. Pain does not radiate. No sensory deficit or weakness in herlegs. Paraspinal muscle tenderness and spasm are also noted. What is Differential? |
Lumbar muscle strain
disk herniation AAA vertebral compression fracture |
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45 y/o F
presents with low back pain that started after she cleaned her house. Pain does not radiate. No sensory deficit or weakness in herlegs. Paraspinal muscle tenderness and spasm are also noted. What is Workup? |
XR - L-spine
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45 y/o M
presents with pain in the lower back and legs during prolonged standing and walking Pain is relieved by sitting and leaning forward (e.g., pushing a grocery cart). What is Differential? |
Lumbar spinal stenosis
lumbar muscle strain tumor in vertebral canal peripheral vascular disease |
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45 y/o M
presents with pain in the lower back and legs during prolonged standing and walking Pain is relieved by sitting and leaning forward (e.g., pushing a grocery cart). What is Workup? |
XR - L-spine
MRI - L-spine (preferred) CT - L-spine ankle-brachial index |
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17 y/o M
presents with low back pain that radiates to the left leg and began after he fell on his knee during gym class. He also has area of loss of sensation in his left foot. The pain and sensory loss do not match any known distribution. He insists on requesting a week off from school because of his injury. What is Differential? |
Malingering
lumbar muscle strain disk herniation knee or leg fracture ankylosing spondylitis |
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17 y/o M
presents with low back pain that radiates to the left leg and began after he fell on his knee during gym class. He also has area of loss of sensation in his left foot. The pain and sensory loss do not match any known distribution. He insists on requesting a week off from school because of his injury. What is Workup? |
XR - L-spine, knee
MRI - L-spine |