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Flashcards in Ortho lab final Deck (6)
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1

Diagnostic cluster for lumbar stenosis

1. BL sx
2. leg pain > back pain
3. Pain during walking/standing
4. Pain relief upon sitting
5. Age >48yr

1/5 is 96% sensitivity, low 0.19 neg LR
4/5 is pos LR of 4.6 and post-test probability 76%

2

Diagnostic cluster for cauda equina syndrome

- Rapid onset of sx (24hr)
- Hx back pain
- Urinary retention
- Loss of sphincter tone
- Sacral sensation loss
- LE weakness or gait loss

3

Diagnostic cluster for lumbar radiculopathy

- Dermatomal pattern of sx
- Pain with cough, sneezing, or straining
- More pain on sitting
- Subjective muscle weakness
- Subjective sensory loss
- Motor loss
- + SLR
- UL ankle reflex

4

Diagnostic cluster for lumbar compression fx

- Age >50 (0.84/0.61)
- Age >70 (0.22/0.96)
- Trauma
- Adequate trauma (may be minor in elderly)
- Corticosteroid use

5

Diagnostic cluster for spine cancer

- Age >50
- Hx cancer
- Failure to improve in 1 month of therapy
- No relief with bed rest
- Duration of 1 month
- Insidious onset
- Constitutional sx

Age >50 + cancer hx + unexplained weight loss or failure of conservative tx (100% sens/60% spec)

6

Diagnostic cluster ankylosing spondylitis

- Age at onset 3mo
- Improved by exercise