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Back pain

  • Common ddx

    • lumbosacral strain, disc herniation, sciatica, pregnancy, osteoarthritis, sacroiliitis, shingles, kidney stone
  • Serious ddx

    • compression fracture, cauda equina, osteomyelitis, spinal mass, abscess, osteosarcoma, referred pain from GI, pyelonephritis, AAA, aortic dissection, pancreatitis
  • Labs

    • xray if osteoarthritis
    • CT if vertebral tenderness, incontinence or past cancer hx
    • MRI if positive straight leg test or neuro sx
  • Other ddx

    • ankylosing spondylitis, spondylolisthesis, spinal stenosis, Paget disease, MM, tuberculosis, aneurysmal bone cyst, osteoid osteoma, hyperparathyroidism
  • HPI

    • onset
    • triggering event
    • aggravation: flexion, extension
    • alleviation: flexion, extension
    • quality
    • quantity
  • ROS

    • fever
    • rash
    • leg pain
    • chest pain
    • upper abdominal pain
    • flank pain
    • incontinence
    • numbness, tingling, weakness
    • trauma, activity
    • hearing loss
  • PMH

    • prostate cancer, breast cancer, melanoma
  • Px

    • inspect: scoliosis
    • skin: rash, bruises, deformity
    • ROM
    • palpate vertebra
    • straight leg test
    • leg neuro: strength, reflex, sensation
    • CVA tenderness
    • prostate exam for men

  • Print | Citations

    Disclaimer: MDHero Workups is for educational use only, and is not meant to replace the clinical judgement of a professional. We do not guarantee the accuracy of any information on this website.