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Exercise 1
Compare Maigne’s syndrome and osteoporotic compression fracture of at
the thoracolumbar junction
Exercise 3
This exercise will require some investigation on your part
You are required to ask for any additional information in the Q&A moodle chat.
However, when you ask for more information you must identify specifically what
information you want and why (ie. What differential diagnoses are you
considering and what will the information provide to help you)
Case History
Mark, 12yom, presented to your office with his Mum. Mark’s mother explained
that he has been complaining of back pain for the past few weeks, maybe longer.
She is unaware of any particular injury that started this and Mark doesn’t recall
any specific injury either. She explains he is a typical boy, plays soccer and rides
at the mountain bike park a few times a week. She would consider him relatively
active but he does like his ‘devices’ when he’s allowed. Mark says the pain is
‘pretty sore’ sometimes, he guesses it is about 5/10 and when asked to indicate
where it is he runs his hand across the region of the thoracolumbar spine.
Pain is localised around the thoracolumbar spine but not specifically
poinpointed
Minor discomfort on the left when rotated to the left
On palpation, mild tenderness on the left around T11, T12, L1 and
tightness of the erector spinae bilateral but more on the left around
the T/L junction
Pain is constant aching throughout the day and night. He has
awaken a few nights complaining of the pain.
All ranges of motion are achieved and are not restricted, however,
there is increased intensity of the pain on both right and left full
rotation.
No bowel, bladder or changes in urine output or other notable
changes.
Valsalva is not positive and pain is not reproduced in axial
compression test.
Pain is constant and he has stopped playing sports because of the
pain.
Paracetemol eases the aching pain.
He can touch his toes.
On observation there is notable mild thoracolumbar spinal curve,
convex to the right.
No increased kyphosis.
No home/school issues - cheerful outgoing boy
No associated system abnormalities
No yellow flags
No night sweats
No previous episodes or previous treatment
No asymmetry in scapulae height
Differential diagnosis:
Facet syndrome
Growing pains
Exercise 4
Explain Peripheralisation and Centralisation as they apply to the clinical
presentation and treatment of LBP with radiculopathy
Exercise 5
Besides those examples provided in the lecture, what questions might you ask to
determine if a patient has signs and symptoms associated with Cauda Equina
Syndrome?