High-Risk Conditions Presenting as Back Pain
Urgent message: That back pain is common and typically without serious sequelae may result in misdiagnosis and mistreatment. ERICA MARSHBURN, BS, BA, AND JOHN SHUFELDT, MD, JD, MBA, FACEP Many high-risk conditions can present as back pain, is a very frequent presenting complaint in urgent care medicine. Most back pain is muscular in origin and responds well to conservative intervention. However, because of the frequency of the complaint and infrequency of serious sequelae, providers may …
Read MoreClinical Challenge: October, 2011
The patient, an otherwise-healthy 42-year-old, presented with bilateral back pain around the pelvis. View the image taken (Figure 1) and consider what your diagnosis would be. Resolution of the case is described on the next page.
Read More
October 2010
The Case of a 51-year-old Man with Back Pain
Most new third-year medical students can recite the “red flags” of back pain: extremes of age, fever, history of cancer, history of trauma, failure to improve after one month of therapy. Few would fail to consider metastatic disease in a 64-yearold woman with a history of breast cancer and new-onset low back pain, but what about the 51-year-old male without a significant past medical history?
Read More
14-year-old boy with lower back pain stemming from fall
The patient is a 14-year-old boy who presents with low back pain after falling from “a high height” and landing on his feet. Exam is normal except for tenderness in the mid-lumbar region. View the image taken and consider what your diagnosis and next steps would be.
Read MoreClinical Challenge 2
The patient is a 61-year-old male who presents with back pain. The patient’s abdomen is soft. Vitals are stable. View the image taken (Figure 1) and consider what your diagnosis and next steps would be. Resolution of the case is described on the next page.
Read More
A 12-year-old Girl with Back Pain
Urgent message: Back pain in a pediatric patient requires a high index of suspicion. Ominous causes (e.g. cancer, infection), are far more common in the pediatric population. Conversely, mechanical low back pain is far less common, and is a diagnosis of exclusion. Forrest Nguyen, DO Introduction As urgent care physicians, we are responsible for anything that comes through the door. Often, the diagnosis proves to be routine – a viral infection, a sore throat, or …
Read More
December 2009
55-year-old female experienced blow to back from fall
The patient is a 55-year-old female who experienced a blow to the back when she fell while riding a bus. She complains of pain in her neck, shoulder, and back. On examination, you find that her vitals are stable and she has no significant past medical history. View the x-ray taken and consider what your diagnosis and next steps would be.
Read More