Back Pain and Spinal Disorders Flashcards Preview

Orthopedics & Rheumatology > Back Pain and Spinal Disorders > Flashcards

Flashcards in Back Pain and Spinal Disorders Deck (11):

What are the causes of mechanical back pain?

- Lumbar strain/sprain

- Degenerative discs/joints (increase with flexion, sitting, sneezing)

- Degenerative facets/joints (more localised, increased with extension)

- Compression fractures (radiates in belt around chest/abdomen, sudden onset, associated osteoporosis) 


What are the differences between inflammatory and mechancal back pain?


What are the red flags for back pain?

- Saddle anaesthesia

- Reduced anal tone

- Hip or knee weakness

- Generalised neurological deficit

- Progressive spinal deformity


What are yellow flags for back pain? (ABCDEFW)

- Attitudes – towards the current problem

- Beliefs – misguided belief that they have something serious

- Compensation – awaiting payment for an accident/RTA?

- Diagnosis – inappropriate communication, patients misunderstanding what is meant

- Emotions – other emotional difficulties (i.e. depression, anxiety)

- Family – either over bearing or under supportive

- Work relationship


What are the features of disc prolapse?

- Herniated nucleus pulposus

- May be acute

- Straight-leg raise test positive

- Leg pain in dermatomal distribution

- Reduced reflexes

- Sciatica and radiculopathy

- Can lead to Cauda equina syndrome (bilateral sciatica, saddle anaesthesia, reduced anal tone, needs urgent neurosurgical review)


What are the features of infective discitis?

- Fever, weight loss

- Constant back pain

- Immunosuppressed, diabetes, IVDU

- Most commonly staphylococcus aureus

- IV antibiotics and surgical debridement


What are the features of malignany back pain?

- History of malignancy (lung, prostate, thyroid, kidney, breast)

- Constant pain, worse at night

- Systemic symptoms


What are the clinical and radiological criteria for ankylosing sponditis?

- Low back pain and stiffness for >3 months, improves with exercise but not relieved by rest

- Limitation of motion of lumbar spine and chest expansion

- Sacrolitis grade ≥2 bilaterally or 3-4 unilaterally


What are the features of spondylolisthesis?

- Pars-interarticularis defect, asymptomatic in most

- Pain may radiate to posterior thigh

- Increase with extension


What are the features of spinal stenosis?

- Anatomical narrowing spinal canal

- Congenital and/or degenerative

- Often presents with 'claudication' in legs/calves (worse walking, rest in flexed position)


What conditions cause referred pain in the back?

- Aortic aneurysm

- Acute pancreatitis

- Peptic ulcer disease

- Acute pyelonephritis/renal colic