Term
| An overweight 67-year old male hypertensive smoker presents with low back pain and intermittent claudication. On examination of the abdomen, there is a midline pulsatile mass is felt above the umbilicus. Ultrasound of the abdomen shows an abdominal aorta with a diameter of 4 cm. |
|
Definition
| Abdominal Aortic Aneurysm |
|
|
Term
| A 35-year old male presents with low back pain and left heel pain. On examination, there is decreased lumbar flexion, extension and lateral bending. He is HLA B27+ and x-ray of his spine shows a bamboo spine with blurring of both sacroiliac joints. |
|
Definition
|
|
Term
| A 62-year old female presents with low back pain which radiates down the back of both legs. She also is having problems starting urination. On examination, there is saddle anesthesia. Her ankle reflexes are absent. CT scan shows a mass in the spinal canal at the level of L4. |
|
Definition
|
|
Term
| A 46-year old male presents with low back pain which is worse on left lateral bending. On examination, Kemp’s test results in local pain in the left lumbar region. Lumbar x-ray shows imbrication of the left L4/5 facet. |
|
Definition
|
|
Term
| A 53-year old male complains of right lumbar pain which radiates into the back of the right leg. Coughing and straining makes the pain worse. On examination, the SLR on the right side is positive at 600 hip flexion. The WLR is also positive. MRI shows a posterolateral disc herniation of the L4/5 disc. |
|
Definition
| Lumbar Disc Herniation with sciatica |
|
|
Term
| A 60-year old male presents with low back pain and unexplained weight loss. On examination there is tenderness on percussion of the spinous process of L2. CBC shows a mild normochromic normocytic anemia. There is Bence-Jones proteinuria and serum electrophoresis shows an M spike. There are multiple lytic lesions in the spine. |
|
Definition
|
|
Term
| An 83-year old female presents with severe low back pain after slipping in the bathroom. On examination, she has a marked kyphosis. There is spinal tenderness on percussion of the spinous process of L1. Lumbar x-ray shows generalized bone density with few but accentuated trabeculations. The body of L1 is wedge-shaped. CMP shows normal serum calcium and phosphate. Alkaline phosphatase is high. |
|
Definition
| Osteoporosis with Fracture |
|
|
Term
| A 63-year old male presents with fatigue and back pain. There is some hearing loss also. On examination, there is anterior bowing of his tibia. CMP shows an elevated alkaline phosphatase with normal calcium levels. X-ray of the skull shows a cotton wool appearance and there is a brim sign in the pelvic x-ray. |
|
Definition
| Paget’s Disease of the bone |
|
|
Term
| A 56-year old male complains of low back pain which radiates into the buttock and into the back of the right thigh. On examination, external rotation of the right hip results in an increase in the pain in the back of the thigh. Bonnet’s test is positive. |
|
Definition
|
|
Term
| A 55-year old black male presents with low back pain which is worse at night. On examination, there is an hard irregular mass in the left posterior lobe of his prostate. CMP shows an elevated alkaline phosphatase. His PSA is 24 pg/dl. Lumbar x-ray shows an ivory vertebra at L2. |
|
Definition
|
|
Term
| A 21-year old female presents with low back pain, fever, chills, vomiting and dysuria. On examination, there is tenderness on percussing the left costovertebral angle. CBC shows leukocytosis with elevated neutrophils. Urinalysis shows bacteria, nitrites and white blood cell casts. |
|
Definition
|
|
Term
| A 67-year old male presents with low back pain. This pain radiates into the legs and is worse when she walks for more than a quarter mile. The pain is better when she sits down or if she leans forward on her shopping cart when she is in the mall. On examination, the peripheral pulses in the lower limbs are palpable and strong. Lumbar Ct and MRI show the narrowing of the diameter of the lumbar spinal canal. |
|
Definition
|
|
