Flashcards in Lower back pain and sciatica Deck (51)
Loading flashcards...
1
What defines acute lower back pain?
Anything less than 6 weeks
2
What should be evaluated in someone with LBP?
Determine is pain is intrinsic and not referred from elsewhere; AAA
Rule out life threatening disease; in children screen for cancer
Determine whether root compression is present
3
General red flags in back pain?
Failure to improve after 4-6 weeks
Unrelenting night pain or pain at rest
Progressive motor or sensory deficit
4
Cancer red flags
Age >50
Unintended wt loss
Hx of ca
Pain at night and in recumbency
5
Infection red flags
Fever/chills
Recent infection
Immunosuppression
IVDU
Dental status; 60-70% of brain and spinal abscesses have a dental origin
Foreign travel
6
RF for #
Age >50
Osteoporosis
Significant trauma
Chronic steroid use
7
Sy for CES
Bilateral sciatica
Urinary incontinence
Leg weakness
Absent anal tone
Loss of perianal sensation; most sensitive indicator
8
Sy of AAA
Age >60
Male
Abdo pulsating mass
Pain at rest
9
LL neurological exam
SLR
Muscle strength
Sensation; light touch, pin prick, vibration
Deep tendon reflexes
10
Nerve root for flexion of hip
L2,3
11
Nerve root for extension of hip
L4,5
12
Nerve root for extension of knee
L3,4
13
Nerve root for flexion of knee
L5,S1
14
Nerve root fo plantarflexion
S1,2
15
Nerve root for dorsiflexion
L4,5
16
Nerve root for eversion
L4
17
Nerve root for inversion
L5,S1
18
Nerve root for shoulder abduction
C5
19
Nerve root for shoulder adduction
C6,7
20
Nerve root for elbow flexion
C5,6
21
Nerve root for elbow extension
C7,8
22
Nerve root for wrist flexion and extension
C6,7
23
Nerve root for finger abduction
C8,T1
24
Nerve root for finger flexion
C7,8
25
Nerve root for finger extension
C7,8
26
Nerve root for supination
C6
27
Nerve root for pronation
C7,8
28
When should you request an x-ray in LBP?
Young men; SI-joints to exclude ank spon
Elderly; exclude vertebral collapse, # or malignancy
29
What is a CT good for in terms of localisation of pathology of the spine?
Bony pathology; trauma, tumour, infection
Foreign bodies
Implants
Spinal fusion planning
30
