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.
sbogoch
Latest posts by sbogoch (see all)
- EM-CCM Cardiology 3/18/2015:Care of the Post-Arrest Patient - April 9, 2015
- 3/10/2015: Bored of Cardiologists, not Cardiology - March 10, 2015
- Bored review: 3/3/2015 Looking Beyond the Injury - March 3, 2015
- Acute Kidney Injury- caring for the sick patient with new renal disease. - February 28, 2015
- Bored Review: 2/3/2015-EKG Changes that make you go hmmm. - February 3, 2015