MEDI7212 Lecture Notes - Lecture 1: Endocarditis, Spondylolisthesis, Metaxalone
Document Summary
First episode of low back pain usually occurs between 20-40yo. Imaging is often not warranted in most patients with acute low back pain unless symptoms/ signs indicate a serious underlying condition - mri is most appropriate, otherwise ct if mri is contraindicated/ unavailable. Laboratory testing - cbc, esr, crp (infection or bone marrow neoplasm: usually commence 4-6 weeks of treatment before consideration of imaging studies, classification. Disorder of msk system: non-specific (mechanical) back pain, 97% cases of back pain seen in primary care practice, no clear relationship between anatomic abnormalities (imaging) & symptoms. Specific musculoskeletal back pain: clear relationship between anatomic abnormalities and symptoms, #1 lumbar radiculopathy via herniated disc, osteophyte, facet hypertrophy or. Systemic disease affecting spine neuroforaminal narrowing: #2 spinal stenosis, #3 cauda equina syndrome. Spine structures with pain (musculature, ligaments, facet joints, discs) may refer to the thigh region, but rarely below the knee. Sacroiliac joint pain often refers to the thigh & even below the knee.
