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(DDx)
(DDx)
A 65 Y/O F reports a recent fall from standing height, after which she developed acute, localized lower back pain. She has limited ROM and point tenderness over the lumbar spine on physical exam. No neurological deficits noted. What is the most likely diagnosis?
What is an acute fracture?
Patient recovering from recent URI presents a week later with acute low back pain and fever. She also reports chills and fatigue. Physical exam findings significant for temperature of 101.3 F and HR of 103. What red flag symptom in this presentation warrants urgent workup?
What is fever?
After lifting heavy furniture during a move, a young adult male presents with sudden onset low back pain. What is the next step in management?
What is conservative management (i.e. NSAIDs, rest, PT)?
A 43 Y/O M presents with back pain after lifting heavy furniture. He has mild muscle tenderness, but denies radiation of pain. What is the most appropriate treatment?
What is conservative management (i.e. NSAIDs, rest, PT)?
A 30 Y/O M presents with acute low back pain after lifting heavy boxes. He denies any radiating leg pain or numbness. Physical exam reveals tenderness over the lumbar paraspinal muscles, but no neurological signs. What is the most likely diagnosis?
What is lumbar muscle sprain?
A 75 Y/O F presents with acute low back pain that has progressively worsened over the past 4 weeks. She is in remission for breast cancer. On exam, she has bony tenderness and weakness in her legs. What is considered a red flag in this patient's presentation?
What is history of cancer and bony tenderness?
A 70 Y/O M with PMH of osteoporosis complains of lower back pain after recent move. What imaging study will reveal the most likely diagnosis?
What is a plain radiograph of the lumbar spine?
A patient presents with a 6-week history of progressively worsening low back pain with radicular symptoms. MRI shows a herniated disc with nerve root compression. What is the next step in management?
What is epidural steroid injection?
A 63 Y/O M with PMH of hypertension and smoking presents with sudden, severe lower back pain. He is also experiencing sharp pain radiating to his groin and thighs. On physical exam, his BP is 90/60 mmHg. What is the most likely diagnosis?
What is an AAA rupture?
A 45 Y/O F presents with sudden, severe low back pain and describes feeling numbness in the perineal area. She has been unable to use the restroom for the past few hours. What is the most likely red flag in this scenario?
Bonus: What is the syndrome?
What is saddle anesthesia and urinary retention?
What is Cauda equina syndrome?
A 56 Y/O F presents after a fall from standing height. She complains of acute, localized lower back pain. She has limited ROM and point tenderness over the lumbar spine on physical exam. No neurological deficits noted. What is the first-line imaging study?
What is a plain radiograph of the lumbar spine?
A 73 Y/O M with metastatic prostate cancer presents with new-onset severe back pain that is unresponsive to NSAIDs. What is the most appropriate treatment for most likely diagnosis of this patient?
What is radiation therapy for metastasis?
A young male with history of IV drug use presents with severe low back pain, fever, and night sweats. On physical exam, he has point tenderness along the lower lumbar spine. Lab shows elevated WBC count. What is the most likely diagnosis?
What is lumbar osteomyelitis?
An 84 Y/O M with Alzheimer's presents to the clinic with his daughter. His daughter says the patient has been complaining of low back pain. He has also recently stooled his pants. She believes it might be due to age. What from the history warrants further work up?
A 50 Y/O M with PMH of lumbar radiculopathy due to disc herniation presents with sudden worsening of low back pain as well as leg weakness. What is the next step?
What is lumbar spine MRI?
A 19 Y/O F with history of IV drug use presents with severe low back pain, fever, and night sweats. On physical exam, she has tenderness along the lower lumbar spine. Lab shows elevated WBC count. What is the treatment needed to address the underlying cause?
What is antibiotic treatment (vancomycin)?