• Skip to primary navigation
  • Skip to main content
  • Skip to primary sidebar
  • 786-300-3183
  • [email protected]
  • Facebook
  • Twitter
Florida Society of Anesthesiologists

Florida Society of Anesthesiologists

  • About FSA
    • FSA Leadership
      • Distinguished Service Award Past Recipients
      • President Engagement Award Past Recipients
      • FSA Past Presidents
    • FSA Staff
    • Calendar of Events
    • Contact FSA
    • FSA Charter & Bylaws
    • FSA Speakers Bureau
  • Annual Meeting
    • Meeting Info
    • Call For Abstracts
    • Past Posters
      • 2022 FSA Podium and Poster Abstracts
      • 2021 FSA Posters
      • 2020 FSA Posters
      • 2019 FSA Posters
      • 2018 FSA Posters
    • Past Meetings
      • 2022 Annual Meeting Recap
      • 2019 Annual Meeting Recap
      • 2018 Annual Meeting Recap
  • FSAPAC
    • Donate to FSAPAC
    • FSAPAC Donors for 2022
  • Join/Renew Membership
    • FSA Membership Renewal
    • Join the Florida Society of Anesthesiologists (FSA)
  • Member Login
  • Member Section

2019 FSA Posters

P031: LOW BACK PAIN AND LOWER EXTREMITY SYMPTOMS ARE NOT ALWAYS LUMBAR RADICULOPATHY
Katarina Nikolic, MD, Heather Barkin, MD, Danielle Horn, MD, Pham Phung, MD; Jackson Memorial Hospital/UM

INTRODUCTION: Low back pain (LBP) is experienced in 60-80% of adults at some point in their lifetime. The specific anatomic cause of back pain is often impossible to define and only a small percentage of patients have an identifiable underlying cause. However, due to atypical presentation the serious condition such as infection, malignancy, fracture or neurologic disease can be undiagnosed.

The purpose of this presentation is to describe the clinical courses of two patients referred to Pain Clinic for the treatment of mechanical LBP who subsequently developed avulsion fracture of pubic symphysis and neurological symptoms.

CASE 1 PRESENTATION: The first patient is a 69-year-old male with past medical history of malignant melanoma, who was referred to Pain Clinic for the evaluation and treatment of an insidious onset of persistent LBP associated with left lower extremity weakness of 6 months duration.

The patient attended physical therapy (PT) with limited improvement. He denied any history of trauma and only took acetaminophen with marginal pain relief. He had an unremarkable electromyography study and no evidence of nerve compression on magnetic resonance imaging (MRI). 
In our clinic, after a detailed physical exam we found a positive Babinski sign on the left leg and slight hyperreflexia. We referred the patient to a neurologist with the suspicion that his LBP could be cortical in orgin.   MRI brain showed 3.5 cm meningioma.

CASE 2 PRESENTATION: The second patient is a 71-year-old male with history of benign spinal tumor s/p resection, cervical/lumbosacral laminectomy for spinal stenosis and osteomyelitis of the pubic symphysis who presented with new LBP, associated with pain radiating down the right leg. The patient was evaluated by an orthopedic surgeon who recommended PT. The patient‘s history and physical examination were consistent with mechanical neuromusculoskeletal dysfunction and no concerning findings were present that warranted immediate medical referral.

We decided to repeat the MRI which showed erosive changes secondary to the osteomyelitis. The patient  developed an avulsion fracture of the pubic symphysis.

CONCLUSION: These two cases are examples of how vigilant clinicians have to be while investigating the cause of worsening LBP.

In patients with a history of chronic back pain, close attention should be paid to signs that can suggest a pathologic condition.

Primary Sidebar

Subscribe for Email News

FSA Annual Meeting

  FSA 2023 Annual Meeting June 9-11, 2023 * The Breakers, West Palm Beach, FL 📅 Add to your calendar TARGET AUDIENCE This … learn more... about FSA Annual Meeting

Call For Abstracts

If you have any questions, please contact the FSA … learn more... about Call For Abstracts

Copyright © 2023 Florida Society of Anesthesiologists ยท Managed by BSC Management, Inc.