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Clin Med II MSK > Back/Spine > Flashcards

Flashcards in Back/Spine Deck (23)
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1

Majority of acute lower back pain is caused by...

Muscle and/or ligament damage

2

2 most common types of lower back injury

- Muscle strain
- Lumbar ligament sprain

3

Whiplash causes...

Cervical strain

4

Is pain from back strain radicular?

NO

5

Cauda equina syndrome

RARE
Large midline disk herniation that compresses nerve roots

6

Sx of cauda equina syndrome

Severe low back pain w/ B/B incontinence

7

How to diagnose cauda equina syndrome

STAT MRI
Decreased rectal tone

8

Does cauda equina syndrome require surgery?

YES--surgical emergency, decompression (laminectomy)

9

Herniated nucleus pulposus: types (2) and which vertebrae are affected

Cervical: usually posterolateral at C5-C6, C6-C7
Lumbar: L5-S1 (most common), L4-L5

10

Sx of cervical herniated nucleus pulposus

Pain in arm/shoulder, numbness/tingling, pain at rest

11

How to differentiate between rotator cuff and cervical herniated nucleus pulposus?

Rotator cuff=no pain at rest
Cervical herniated nucleus pulposus=pain at rest

12

Sx of lumbar herniated nucleus pulposus
Relieved by?
Exacerbated by?

Sudden onset pain radiates below knee
Relieved w/ bed rest
Exacerbated by coughing, sitting, straining, straight leg raise

13

Diagnostic imaging for herniated nucleus pulposus

MRI (noncontrast for lumbar)

14

Tx of herniated nucleus pulposus

NSAIDs, muscle relaxants, epidural steroids
FAIL meds=surg

15

Ankylosing spondylitis

Chronic inflam progressing to fusion of vertebrae

16

Does pain of ankylosing spondylitis get worse with activity?

NO, it gets better

17

What do labs for ankylosing spondylitis look like?

[+] HLA-B27 gene
Increased CRP and ESR
[-] RF

18

What is typical of ankylosing spondylitis on films?

"Bamboo spine"--squaring of vertebral bodies and loss of curvature

19

What is the leading dx for pts >65 who have spine surg?

Spinal stenosis

20

Sx of spinal stenosis

Dull back pain radiating to LE pain w/ walking or wt bearing, relieved by rest

21

What position relieves pain of spinal stenosis?

"Shopping cart sign"

22

What can cause progressive kyphosis?

TB of spine (Pott's dz)

23

What age is scoliosis typically diagnosed? More common in male or female?

9-15, female