Back pain resident survival guide: Difference between revisions
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{{familytree | | | | | | | | | | A01 | | | | |A01=[[Back pain]]}} | {{familytree | | | | | | | | | | A01 | | | | |A01=[[Back pain]]}} | ||
{{familytree | | | | | | | | | | |!| | | | | | | }} | {{familytree | | | | | | | | | | |!| | | | | | | }} | ||
{{familytree | | | | | | | | | | A02 | | | | | |A02=[[ | {{familytree | | | | | | | | | | A02 | | | | | |A02=[[Sciatica]] present?}} | ||
{{familytree | | | |,|-|-|-|-|-|-|^|-|-|-|-|-|-|-|.| | | | | | }} | {{familytree | | | |,|-|-|-|-|-|-|^|-|-|-|-|-|-|-|.| | | | | | }} | ||
{{familytree | | | B01 | | | | | | | | | | | | | B02 | | |B01=Yes|B02=No}} | {{familytree | | | B01 | | | | | | | | | | | | | B02 | | |B01=Yes|B02=No}} | ||
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{{familytree | E01 | | E02 | | | | | | | | | E03 | | |!| |E01=Proper spinal immobilization, <br>urgent [[CT]] or [[MRI]] to evaluate [[cauda equina syndrome]], <br>Urgent neurosurgical or neurologic consultation|E02=Order plain film of vertebra,<br>order [[ESR]] and/or [[CRP]] if you suspicious of [[osteomyelitis]]. |E03=E03}} | {{familytree | E01 | | E02 | | | | | | | | | E03 | | |!| |E01=Proper spinal immobilization, <br>urgent [[CT]] or [[MRI]] to evaluate [[cauda equina syndrome]], <br>Urgent neurosurgical or neurologic consultation|E02=Order plain film of vertebra,<br>order [[ESR]] and/or [[CRP]] if you suspicious of [[osteomyelitis]]. |E03=E03}} | ||
{{familytree | | | | | |!| | | | | | | | | | |!| | | |!| | | | }} | {{familytree | | | | | |!| | | | | | | | | | |!| | | |!| | | | }} | ||
{{familytree | | | | | F01 | | | | | | | | | F02 | | |!| |F01=Plain film and ESR/CRP | {{familytree | | | | | F01 | | | | | | | | | F02 | | |!| |F01=Plain film and [[ESR]]/[[CRP]] both normal?|F02=F02}} | ||
{{familytree | | | |,|-|^|-|.| | | | | | |,|-|^|-|.| |!| | }} | {{familytree | | | |,|-|^|-|.| | | | | | |,|-|^|-|.| |!| | }} | ||
{{familytree | | | G01 | | G02 | | | | | G03 | | G04 |!| | |G01=Yes|G02=No|G03=Yes|G04=No}} | {{familytree | | | G01 | | G02 | | | | | G03 | | G04 |!| | |G01=Yes|G02=No|G03=Yes|G04=No}} | ||
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{{familytree | | | H01 | | H02 | | | | | |!| | | H03 |'| | | |H01=Provide [[back pain conservative treatment]] for 4-6 weeks unless neurologic deficit is progressive.|H02=H02|H03=H03}} | {{familytree | | | H01 | | H02 | | | | | |!| | | H03 |'| | | |H01=Provide [[back pain conservative treatment]] for 4-6 weeks unless neurologic deficit is progressive.|H02=H02|H03=H03}} | ||
{{familytree | | | |!| | | | | | | | | | |!| | | |!| | | | | }} | {{familytree | | | |!| | | | | | | | | | |!| | | |!| | | | | }} | ||
{{familytree | | | I01 | | | | | | | | | |!| | | I02 | | | |I01=Patient improved|I02=I02}} | {{familytree | | | I01 | | | | | | | | | |!| | | I02 | | | |I01=Patient improved?|I02=I02}} | ||
{{familytree | |,|-|^|-|.| | | | | | | | |!| |,|-|^|-|.| | | |}} | {{familytree | |,|-|^|-|.| | | | | | | | |!| |,|-|^|-|.| | | |}} | ||
{{familytree | J01 | | J02 | | | | | | | |!| J03 | | J04 | | | |J01=Yes|J02=No|J03=J03|J04=J04}} | {{familytree | J01 | | J02 | | | | | | | |!| J03 | | J04 | | | |J01=Yes|J02=No|J03=J03|J04=J04}} | ||
Revision as of 18:18, 26 July 2013
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Back pain Microchapters |
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Diagnosis |
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Treatment |
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Lecture |
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Case Studies |
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Back pain resident survival guide On the Web |
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American Roentgen Ray Society Images of Back pain resident survival guide |
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Risk calculators and risk factors for Back pain resident survival guide |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor-In-Chief:Hilda Mahmoudi M.D., M.P.H.[2]
Definition
Back pain is pain felt in the back that may originate from the muscles, nerves, bones, joints or other structures in the spine.
Causes
Life Threatening Causes
Common Causes
- Discopathy
- Idiopathic lumbago
- Trauma due to lifting
- Ligament strain
- Radiculopathy
- Posterior Rami Syndrome
Management
| Back pain | |||||||||||||||||||||||||||||||||||||||||||||||||
| Sciatica present? | |||||||||||||||||||||||||||||||||||||||||||||||||
| Yes | No | ||||||||||||||||||||||||||||||||||||||||||||||||
| Acute radiculopathy with urinary retention, saddle anesthesia and bilateral neurologic findings AND/OR progressive motor weakness | C02 | ||||||||||||||||||||||||||||||||||||||||||||||||
| Yes | No | Yes | No | ||||||||||||||||||||||||||||||||||||||||||||||
| Proper spinal immobilization, urgent CT or MRI to evaluate cauda equina syndrome, Urgent neurosurgical or neurologic consultation | Order plain film of vertebra, order ESR and/or CRP if you suspicious of osteomyelitis. | E03 | |||||||||||||||||||||||||||||||||||||||||||||||
| Plain film and ESR/CRP both normal? | F02 | ||||||||||||||||||||||||||||||||||||||||||||||||
| Yes | No | Yes | No | ||||||||||||||||||||||||||||||||||||||||||||||
| Provide back pain conservative treatment for 4-6 weeks unless neurologic deficit is progressive. | H02 | H03 | |||||||||||||||||||||||||||||||||||||||||||||||
| Patient improved? | I02 | ||||||||||||||||||||||||||||||||||||||||||||||||
| Yes | No | J03 | J04 | ||||||||||||||||||||||||||||||||||||||||||||||
| Reassure patient, advise to stay active, prescribe medication for pain if necessary, discourage bed rest. | K02 | ||||||||||||||||||||||||||||||||||||||||||||||||