Lower back pain and sciatica Flashcards Preview

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Flashcards in Lower back pain and sciatica Deck (51)
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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

What is an MRI good for in terms of localisation of spinal pathology?

Soft tissue; tumours, infection
Bone oedema
Can see spinal cord MUCH better