Thoracic Spine Complaint Flashcards Preview

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Flashcards in Thoracic Spine Complaint Deck (47)
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1
Q

acute pain in thoracics often from

A

compression fractures or muscle spasm

2
Q

in younger pts with pain or deformity:

A

scoliosis and hyperkyphosis

3
Q

in older pts with pain or deformity:

A

chronic postural problems or long term scoliosis

4
Q

in seniors with pain or deformity

A

compression fractures

5
Q

in older pts with weight loss, history of cancer, night pain or fever:

A

look for cancer or infection

6
Q

if there is stiffness with normal ROM:

A

posturally strained muscles

7
Q

if there is deformity possible:

A

compression fracture, Scheuermann’s, scoliosis, postural issue

8
Q

if there is scapular winging:

A

scoliosis or muscle weakness (traps and serratus anterior)

9
Q

if there is high scapula:

A

Sprengel’s deformity

10
Q

if there is buffalo hump:

A

cushings or from corticosteroid use

11
Q

if there is Dowagers hump or acute angle kyphosis:

A

compression fracture

12
Q

if there is hyperkyphosis in adolescents:

A

Scheuermann’s and postural problems

13
Q

if there is referred pain from lower costovertebral area:

A

from kidney

14
Q

if there is referred pain from mid thoracic or scapular area:

A

from gallbladder

15
Q

management for infections, tumor, fractures, progressive scoliosis, active Scheuermann’s:

A

orthopedic consultation

16
Q

management for inactive Scheuermann’s, non progressive scoliosis, facet syndrome:

A

conservative care

17
Q

fever with night pain and/or history of IV drug use

A

do thoracic spine xrays looking for infection

18
Q

older pt with weight loss, history of cancer, night pain, unresponsive to conservative care

A

do thoracic spine xrays looking for metastasis or multiple myeloma

19
Q

older pt with trauma and/or history of corticosteroid use, or postmenopausal pt, or pt with major trauma

A

do thoracic spine xrays to look for compression fracture

20
Q

younger pt with no fever, pain at night relieved by aspirin

A

do thoracic spine xrays to look for osteoid osteoma

21
Q

pt has associated chest pain

A

do thoracic spine xrays and/or electrocardiogram

22
Q

traumatic onset of pain or pain with inspiration

A

do chest and rib xrays

23
Q

insidious onset of constant pain and pt is hyperkyphotic

A

do prone extension test to differentiate structural from functional kyphosis

24
Q

scoliosis is suspected

A

do adam’s test to differentiate structural from functional scoliosis

25
Q

insidious onset of pain in a dermatomal, unilateral pattern

A

herpes zonser/shingles

26
Q

pain that may radiate along rib, pain may increase with Valsalva, deficit in corresponding dermatome or myotome

A

neuritis or radiculitis

27
Q

pain that may radiate along rib, pain increased with hyperextension, positive Kemps, end range restriction to the side of involvement

A

facet syndrome

28
Q

active Scheuermann’s:

A

skeletal immaturity

29
Q

inactive Scheuermann’s:

A

skeletal maturity

30
Q

if kyphosis persists with prone extension test

A

structural

31
Q

if kyphosis improves with prone extension test

A

functional

32
Q

anterior step defect and zone of impaction on xray

A

compression fracture

33
Q

decreased height of more than half of the anterior vertebral body may suggest

A

unstable fracture

34
Q

management of new or unstable fracture

A

orthopedic consultation

35
Q

decreased posterior vertebral body height

A

pathological fracture

36
Q

diff di for pathological fracture in older pt

A

osteoporosis, lytic mets, multiple myeloma

37
Q

diff di for pathological fracture in young pt

A

eosinophilic granuloma

38
Q

tests to do for lytic mets

A

bone scan, MRI, biopsy

39
Q

tests to do for multiple myeloma

A

PEP, skeletal survey, MRI, biopsy

40
Q

localized mid back pain, in young males (10-25), pain worse at night relieved by salicylates

A

osteoid osteoma

41
Q

diff di of missing pedicles

A

congenital, destructive, surgical

42
Q

reasons for destructive changes with missing pedicles

A

bone tumor, soft tissue tumor, infection

43
Q

diff di with decreased disc height/joint space

A

DDD, DJD, inflammatory, developmental, infection

44
Q

Riser’s sign

A

growth plate along top of iliac crest

45
Q

rotational component of scoliosis

A

Nash-Moe method

46
Q

if a vertebral body is darker with T1 MRI and lighter with T2 MRI, is the injury new or old?

A

new

47
Q

diff di for ivory vertebrae

A

blastic mets, lymphoma, pagets