Bored review: 11/4/14- Back Pain

A 73-year-old female presents in Fast Track (of Andy’s stupid fictitious hospital) with one week of back pain, worse at night. The patient is independent with all ADLs. No recent injury, no fever. The patient does report decreased appetite. Exam shows bony tenderness of thoracolumbar spine. What do you do? Analgesia and discharge? Or perform imaging.answer.....

Warning signs that back pain is not “JUST” a muscle strain:

-fever, IVDU, history of malignancy, age less than 16, new back pain in patient over 50, pain lasting greater than 6 weeks, night pain, urinary retention, neuro complaints like paraesthesias/weakness, anticoagulants or coagulopathy, trauma.

IF THE PATIENT GIVES THE ABOVE HISTORICAL DETAILS, LOOK FOR A MORE SINISTER CAUSE FOR THE BACK PAIN. WORD.

 

By Dr. Grock and Slappy Bagooch.

Tintinalli, 8th Ed.

The views expressed on this blog are the author's own and do not reflect the views of their employer. Please read our full disclaimer here. Any references to clinical cases refer to patients treated at a virtual hospital, Janus General Hospital.