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CC July 2017 Low back pain

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echoecho's version from 2017-07-16 22:14

Section

Question Answer
How many people out of 10 people will have low back pain in their lifetime?9
In 2006, the cost of low back pain was estimated to be how many billion of dollars per year? Two-thirds of which was attributed to what two things?1) $100 billion dollars 2) lost wages and reduced productivity
What % of the causes of low back pain are benign and resolve spontaneously?90%
3 categories of low back pain?1) acute (pain lasting < 4 weeks) 2) subacute (pain lasting 4-12 weeks) 3) chronic (pain lasting > 12 weeks)
What % of the population with acute back pain progress to chronic back pain?10%
To dx and rx low back pain, what 2 things are needed?1) careful history 2) physical exam
List the red flags elicited in the history?1) pain worse at rest or at night 2) hx of trauma 3) hx of chronic infection or glucocorticoid use 4) age > 70 5) fever 6) chills 7) weight loss 8) hx of cancer 9) symptoms of cauda equine syndrome (saddle numbness, urinary retention, fecal incontinence)
List the components of a complete physical exam for low back pain?1) back appearance 2) strength 3) reflexes 4) sensations 5) ROM 6) SLRT
*** Is imaging necessary if red flags are absent, the exam is consistent with an acute condition? Does imaging improve clinical outcomes if red flags are absent?1) no 2) no
What imaging may be necessary if red flags are present?1) x-rays 2) CT scan 3) MRI 4) bone scan
Regarding indications for imaging, if the clinical setting shows acute, subacute or chronic uncomplicated low back pain. No red flags. No prior management, what imaging tests are indicated and give the rating scale for each imaging (ACR rating scale 1,2,3 = not usually appropriate; 4,5,6 = may be appropriate; 7,8,9 = usually appropriate)?1) MRI w/o contrast = rating 2; 2) LS x-ray = rating 2; 3) CT lumbar spin = rating 2
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Regarding indications for imaging, if the clinical setting shows concerns for cancer, infection or immunosuppression, what imaging tests are indicated and give the rating scale for each imaging (ACR rating scale 1,2,3 = not usually appropriate; 4,5,6 = may be appropriate; 7,8,9 = usually appropriate)? 1) MRI with and w/o contrast = rating 8 2) CT without contrast if contraindication to MRI = rating 6
Regarding indications for imaging, if the clinical setting shows......, what imaging tests are indicated and give the rating scale for each imaging (ACR rating scale 1,2,3 = not usually appropriate; 4,5,6 = may be appropriate; 7,8,9 = usually appropriate)?
Regarding indications for imaging, if the clinical setting shows ....., what imaging tests are indicated and give the rating scale for each imaging (ACR rating scale 1,2,3 = not usually appropriate; 4,5,6 = may be appropriate; 7,8,9 = usually appropriate)?
Regarding indications for imaging, if the clinical setting shows ....., what imaging tests are indicated and give the rating scale for each imaging (ACR rating scale 1,2,3 = not usually appropriate; 4,5,6 = may be appropriate; 7,8,9 = usually appropriate)?
Regarding indications for imaging, if the clinical setting shows ....., what imaging tests are indicated and give the rating scale for each imaging (ACR rating scale 1,2,3 = not usually appropriate; 4,5,6 = may be appropriate; 7,8,9 = usually appropriate)?