Diagnostic Pitfalls Cancer and metastasis of the spine can mimic degenerative back and neck pain...
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Diagnostic Pitfalls • Cancer and metastasis of the spine can mimic degenerative back and neck pain • Early referral and early and wider use of MRI scans is essential to avoid missing serious pathology • High Index of suspicion vital. Always ask history of previous malignancy • 20% have no history of a primary malignancy
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Transcript of Diagnostic Pitfalls Cancer and metastasis of the spine can mimic degenerative back and neck pain...
Diagnostic Pitfalls• Cancer and metastasis of the spine can mimic
degenerative back and neck pain
• Early referral and early and wider use of MRI scans is essential to avoid missing serious pathology
• High Index of suspicion vital. Always ask history of previous malignancy
• 20% have no history of a primary malignancy
PC. F=62.
• C/o LBPx 6 months• Progressively worse• Radiates to left hip and thigh area• No red flags• Pain increased on sitting an walking• Still at work
PC. F=62
• O/E: Tender Left L3-5 area• SLR on left +ve at 60 degrees• Left SI joint tender• Reduced sensation left leg
PC. Xrays.
Narrowing L45 Disc space
Early OA in Left Hip
Rx- Physio, Pain killers, Exercise programs
Not settling
PC. MRI ScansMetastasis at T5, T8 and
L1, with bulging at T5.
? Left Hip pain referred from L1 area
No known Primary
Treated by radiotherapy.
