Low back pain differential diagnosis ppt 2019 back pain. Learning point the differential diagnosis of back pain in children includes. Approach to back pain department of family medicine 3 differential diagnosis of back pain mechanical lower back pain the most common cause of back pain. Diagnosis of low back pain originating in the facet joints is difficult, and has traditionally relied upon invasive tests.
May 25, 2018 differential diagnosis for abdominal pain based on history and physical examination in spite of the fact that area of stomach pain or abdominal pain directs the underlying assessment, related signs and indications are prescient of certain reasons for pain in the abdomen and can limit the differential diagnosis. What are your differential diagnoses for acute low back pain. When caring for a patient and developing a back pain differential diagnosis, remember to consider age, the history, physical exam findings, laboratory results, and imaging if needed. Differential diagnosis for back pain chronic common and important causes of back pain chronic for doctors and medical students this page is currently being written and will be available soon. Chronic degenerative arthritis and spinal stenosis most common cause of cervical radiculopathy trauma often multiple levels, due to nerve root stretch epidural abscess back pain, fever, risk factors epidural metastases e.
How inflammatory back pain symptoms lead to an ankylosing spondylitis diagnosis. Figure 71 reorganizes the differential diagnosis using pivotalpoints and outlines the diagnostic approach to low back pain. Acute, subacute, or chronic low back pain with movement coordination. A 38yearold black woman with a medical history significant for hypertension and depression presented to the emergency department with a 2week history of lower back pain. At the end of the seventies studies were contradictories. First, is a single joint or are multiple joints involved is the joint pain articular or polyarticular. Nov 01, 2010 therefore with bilateral spondylolysis or bilateral fractures the vertebral pedicle slips anteriorly. Jan 14, 2020 chronic pain syndrome cps is a common problem that presents a major challenge to healthcare providers because of its complex natural history, unclear etiology, and poor response to therapy. L ow back pain, with pain radiating to the lower extremities, is common in patients referred to a spine center. Definitiondefinition back pain can be defined as pain of any natureback pain can be defined as pain of any nature felt in any region ranging from the thoracicfelt in any region ranging from the thoracic spine to the pelvis. Cutting pain andor back pain particularly if it has migrated down along thorax suggests aortic dissection. Although motion palpation findings have limited value in differential diagnosis.
The greater trochanter can be felt along the side of your hip. Nearly a third of people seeking treatment for low back pain will have persistent moderate pain for one year after an acute episode. To be updated when it is complete please like us on facebook, follow us on twitter or subscribe on youtube using. The five deadly causes of chest pain other than myocardial. Find powerpoint presentations and slides using the power of.
Sometime back pain can be related to infections, cancer, fractures, or even other organs such as the kidney, bladder, etc. Despite the availability of modern diagnostic tools, the cause of the pain generator is often unidentifiable. The differential diagnosis of generalized pain sciencedirect. A good physical exam and possibly imaging can help diagnose the cause of low. Kuslich et al 57 identified intervertebral discs, facet joints, ligaments, fascia, muscles, and nerve root dura as tissues capable of transmitting pain in the low back. Feverweaknesssyncopealtered mental statusseizuredizziness and vertigoheadachesore throatdyspneachest painabdominal painnausea and vomitinggastrointestinal bleedingacute pelvic painback pain causes of back pain. This collection features the best content from afp, as identified by the afp editors, on back pain and related issues, including chronic and acute low back pain, lumbar spinal stenosis, sciatica. Atraumatic shoulder pain for the primary care physician. John visits his doctor complaining of pain in his chest. For many individuals, episodes of back pain are selflimited. Apr 01, 2016 an overview of the differential diagnosis and treatment of specific low back pain for patients who need immediate medical attention is given in etable 3, and a comparable table for patients with nonurgent problems is given in etable 4.
Our new crystalgraphics chart and diagram slides for powerpoint is a collection of over impressively designed datadriven chart and editable diagram s guaranteed to impress any audience. Patients who continue to have back pain beyond the acute period four weeks have subacute back pain lasting between 4 and 12 weeks and may go on to develop chronic back pain persists for. To provide guidelines for assessment of the painful wrist an algorithm was developed to encourage a structured approach to the diagnosis and management of these patients. Furthermore, within the consideration of lifethreatening causes, patients may be suffering from coronary causes, as well as pulmonary embolism, aortic dissection, aortic rupture, pneumothorax, or.
Adult with low back pain or back related leg symptoms for pain radiating. Jan 14, 2016 cardinal presentations this post is part of a series called cardinal presentations, based on rosens emergency medicine 8th edition. Mechanical lbp refers to pain that is diffusely related to soft tissues. The approach to the diagnosis of low back pain must include a knowledge of the pathology and the natural history of the common. Cardinal presentations this post is part of a series called cardinal presentations, based on rosens emergency medicine 8th edition. More than 80% of all health care costs can be attributed to chronic lbp.
Chronic low back pain at least three months duration1 is a major health problem, can be disabling, and imposes an enormous social and economic burden on the community. Back pain tests learn what to expect when you see your doctor about back pain. Differential diagnosis of low back pain sciencedirect. Sep 10, 2010 the relationship between back pain and scoliosis is not clear. Low back pain lumbar back pain is defined as pain in the back from the level of the lowest rib down to the gluteal fold, with or without radiation into the legs. A diagnosis of fibromyalgia may seem highly probable even from the referral letter, or after a few leading questions during the consultation. In the common presentation of acute low back pain, pain develops after movements that involve lifting. An algorithmic approach for clinical management of chronic spinal pain epidemiology of various identifiable sources of chronic low back pain. Low back pain that has been present for longer than three months is considered chronic. A free powerpoint ppt presentation displayed as a flash slide show on id. The differential diagnosis of fibromyalgia fm is large, given the number of conditions that can present with signs or symptoms of fm, such as pain, fatigue and sleep disturbance, and symptoms of cognitive dysfunction and psychiatric disease. Jan 24, 2017 mechanical low back pain is one of the most common patient complaints expressed to emergency physicians in the united states accounting for more than 6 million cases annually. May 11, 2012 a 16 year old man presented to the emergency department with a two week history of back pain in the left lower lumbar region.
The issue of low back pain lbp is as common as it is perplexing. Most low back pain is caused by conditions that are troublesome but not progressive or lifethreatening. Reports of mac infections in the setting of sle are fairly numerous, and have included a. The differential diagnosis of abdominal pain is often a challenge, however, because many symptoms and signs are nonspecific. The differential diagnosis of joint pain can be framed with the use of 3 pivotal questions. With spondylolysis or spondylolisthesis, the patient will usually complain of increased pain with hyperextension of the lower spine. Low back pain academy of orthopaedic physical therapy. Differential take your pet mac for a walk the 6 deadly causes of chest pain.
His general practitioner had suspected a urinary tract infection after a urine dipstick tested positive for. Differential diagnosis of low back pain ppt xpowerpoint. A 38yearold woman with an osteolytic rib lesion chest. Although its not lifethreatening it can cause serious problems. Intrinsic spine compression fracture history of trauma unless osteoporotic, point tenderness at spine level.
One of the most important things you can do to ensure a prompt and accurate diagnosis is to keep track of your back pain symptoms. She also complained of chronic midthoracic back pain in the setting of. Back pain that is eased by sitting up and leaning forward pancreas. In patients with positive findings, the initial patientspecific differential is quickly limited. Chart and diagram slides for powerpoint beautifully designed chart and diagram s for powerpoint with visually stunning graphics and animation effects. Differential diagnosis and management of back pain chronicpain mcn.
Find powerpoint presentations and slides using the power of, find free presentations research about differential diagnosis of low back pain ppt. Approximately 5% of patients with low back pain disability account for 75% of costs associated with low back pain diagnosis and treatment of low back pain. Generally, back pain is classified as mechanicalgenerally, back pain is classified as. Started in 1995, this collection now contains 6767 interlinked topic pages divided into a tree of 31 specialty books and 732 chapters. A read is counted each time someone views a publication summary such as the title, abstract, and list of authors, clicks on a figure, or views or downloads the fulltext.
Symptoms include abdominal pain, back pain, and fever. These germs are very common in food, water, and soil. To aid in the clinical diagnosis of this condition, the senior author. Old longterm followup studies reported no greater incidence or degree of back pain in adult scoliosis than in normal population when matched for age and sex. Differential diagnosis of back pain by painweek issuu. Differential diagnosis of back pain in adult scoliosis non. The pain came on suddenly while he was bending over and persisted as a dull ache. A 39 year old primigravid woman who was 36 weeks pregnant presented to the maternity unit with a one day history of worsening intermittent abdominal pain and vomiting.
Lower back pain is now a days common in males, especially in 50 or more than 50 years old males. Mar 01, 2009 magnetic resonance mr imaging is a powerful diagnostic tool that can be used to help evaluate spinal infection and to help distinguish between an infection and other clinical conditions. Chapter 9 differential diagnosis overview differential diagnosis involves the ability to quickly differentiate those problems of a serious nature from those that are. Although most back pain is generally benign a significant percentage of the population will develop chronic pain and disability box 1. At initial presentation, trained physicians can predict with. The differential diagnosis of chest pain syndrome is broad and disparate, including disease processes that range from nonurgent to life threatening. If the pain involves just 1 joint, the next question is, is the pain articular or extraarticular. A sinister cause of back pain in a young man the bmj. You can use an app like arthritispower to document when your back pain gets worse and when it eases up. The pain was colicky in nature, with no radiation, and it was worse when she was lying flat. Lbp is thought to be a chronic issue in approximately 10% of the u. Back pain associated with acute or chronic vertebral compression.
The etiology of low back pain may be difficult to determine at times because of the number of diverse anatomic structures located in or near the low back region. When symptoms persist for several months over 3 months chronic back pain results. When a patient presents with a problem that appears likely to be mechanical, it may well be the case, but you need also to consider inflammatory conditions, infectious problems, fractures, referred and functional pain. An unusual extraspinal cause of bilateral leg pain archives of. Differential diagnosis of a patient with low back and toe pain. The head and neck region is packed with complex anatomy, its. View and download powerpoint presentations on differential diagnosis of low back pain ppt.
The initial goal is to identify patients who have a serious or even lifethreatening etiology for their symptoms and require urgent intervention. Back pain could be mechanical, pathologic or physiologic 6. Mechanical low back pain is one of the most common patient complaints expressed to emergency physicians in the united states accounting for more than 6 million cases annually. Back pain pathophysiology free download as powerpoint presentation. Adult with low back pain or back related leg symptoms for pain in the lower back is extremely common.
Low back pain is the leading cause of long term disability worldwide. May 03, 20 course objectives identify primary and secondary pain generators that contribute to back pain. Spinal xray spinal xrays are pictures of the spine. This is a narrated powerpoint instructing osteopathic medical students on the differential diagnosis and treatment of low back pain. Differential diagnosis and management of back pain youtube.
Clinical tests compared to mri results patients who report hip pain often point to the side of the hip over the region of the greater trochanter. Back pain is the primary cause of disability in people back pain lbp is second only to upper respiratory problems for physician visits each year. This is a very rare occurrence but should be considered in the differential diagnosis of individuals with intrathecal infusion systems who develop. Md nazrul islam shaheedsuhrawardy medical college hospital,mbbs, m. By using pubmed database and low back pain, pelvic girdle pain, pregnancy as. Acute low back pain michigan medicine university of michigan. Em basic chest pain history of stress tests or caths pearl. Patients whose symptoms include widespread, diffuse musculoskeletal pain are commonly referred for rheumatological evaluation, even when the underlying cause may lie outwith the remit of rheumatology. This helps you give your presentation on back pain in a conference, a school lecture, a business proposal, in a webinar and business and professional representations. Differential diagnosis the prevailing belief among patients and clinicians that low back pain is predominately caused by damage or injury to structures in the back, is misguided.
Acute low back pain is commonly encountered in primary care practice. In determining the cause of the back pain based on your knowledge of anatomy what nerve roots might be involved. Additional issues in pregnant women include consideration of the. The pain was associated with him waking up at night feeling sweaty and feverish. An uncommon clinical presentation of ovarian torsion. In patients with positive findings, the initial patientspecific differential is quickly limited to serious systemic causes of back pain or specific musculoskeletal back pain. In the differential diagnosis of low back pain, the main point is that 97% of cases are mechanical figure 1. Todd e davenport, pt, dpt, ocs kornelia kulig, pt, phd, fapta chris a.
Approximately two thirds of adults are affected by mechanical low back pain at some point in their lives, making it the second most common complaint in ambulatory medic. An algorithmic approach for clinical management of chronic. The approach to acute abdominalpelvic pain in pregnancy is similar to that in the nonpregnant state, with some additional challenges. A joint clinical practice guidelines from the american college of physicians and the american pain society annals of internal medicine.
An overview of the differential diagnosis and treatment of specific low back pain for patients who need immediate medical attention is given in etable 3, and a comparable table for patients with nonurgent problems is given in etable 4. Assessment of back pain differentials bmj best practice. Mar 14, 2014 powerpoint is the worlds most popular presentation software which can let you create professional back pain powerpoint presentation easily and in no time. Ppt differential diagnosis powerpoint presentation free. An episode of low back pain is called acute if it has arisen for the first time in a patients life, or after a pain free interval of at least six months, and lasts no longer than. In contrast, most bacterial infections in the spine start at the intervertebral disc. Free download back pain powerpoint presentation slides.
Differential diagnosis low back pain clinical resource. This visit was her second in 1 week with the same symptoms, after attaining minimal pain relief with cyclobenzaprine. Mycobacterium avium complex mac is a group of bacteria related to tuberculosis. Generally, back pain is classified as mechanicalgenerally, back pain is classified as mechanical or nonmechanical and can be. Here are some simplified examples of what a differential diagnosis may look like for some common conditions. Radiculopathy ddx litfl ccc differential diagnosis. Back pain is the primary cause of disability in people back pain lbp is second only to upper. Chest pain is one of the most common symptoms in the emergency department, as well as in primary health care.
Ovarian torsion usually presents with sudden onset of severe, unilateral lower abdominal pain, associated with nausea and vomiting. The diagram below provides a simple diagnostic and management guideline that should be used in. Mar 04, 2016 low back pain most bouts of back pain ease quickly, usually within a week acute back pain. But not always if your diagnosis just isnt falling into any of our usual dental bins, back up and think about the rest of the body. Acute, subacute, or chronic low back pain with movement. Back pain, acute low back pain without radiculopathy. In every patient with back pain, it is essential to systematically ask about and look for the clinical clues and pivotal points associated with serious causes of back pain. Objective chronic wrist pain can be difficult to manage and the differential diagnosis is extensive. There had been no vaginal bleeding, no change in bowel habit, and no urinary symptoms. Differential diagnosis for back pain chronic oxford. In most cases of spinal infection, mr images show typical findings such as vertebral endplate destruction, bone marrow and disk signal abnormalities, and. Back pain is a common presentation to the emergency department. Intrinsic spine compression fracture history of trauma unless osteoporotic, point tenderness at. A 42yearold male reports pain in his lower back for the past month.
It is associated with disability, health care expenses, and a loss of wages and productivity. Doctors give trusted, helpful answers on causes, diagnosis, symptoms, treatment, and more. The purpose of this case report is to describe the successful physical therapist screening and subsequent medical differential diagnosis of a 36 yearold male with chronic lower back and toe pain. Feverweaknesssyncopealtered mental statusseizuredizziness and vertigoheadachesore throatdyspneachest painabdominal painnausea and vomitinggastrointestinal bleedingacute pelvic painback pain causes of back pain key historical findings onset acute onset. Therefore with bilateral spondylolysis or bilateral fractures the vertebral pedicle slips anteriorly. An accurate diagnosis is essential for both acute and chronic low back pain conditions.
Estimates for one year prevalence range from 22% to 65% and for lifetime prevalence from 11% to 84%. Describe how routine examinations may be deficient in providing adequate differential diagnosis of. Back pain is usually related to arthritic changes to the spine. These structures may be causing direct or referred pain patterns.
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