An Uncommon Cause Of Back Pain - Page #1

Author: Ashley Karpinos, MD
Co Author #1: Katie Rizzone, MD

Patient Presentation:
A 17-year-old healthy male high school football player presented to the Sports Medicine Clinic with 6 days of left-sided lower back pain.

Six days prior to presentation, he had sustained a helmet tackle to the back. He was treated with ice and NSAIDs and was able to continue practicing until the day prior to presentation. His athletic trainer removed him from practice and referred him to the Sports Medicine Clinic due to increasing back pain. Upon presentation, he began experiencing nausea, vomiting, chills, and pre-syncope with standing. He was unable to find a comfortable position.

Physical Exam:
Vital signs: Temp 102.9, HR: 105, BP: 120/80, RR:8, and O2 saturation level was 97% on room air. In general, he was an athletic male who was ill-appearing with rigors. He was rolling back and forth on the table and unable to lie on his back secondary to pain. On musculoskeletal exam, he had poor segmental motion, extreme pain with attempted lumbar flexion, point tenderness over L2, L3, and L4, and involuntary spasm of paraspinous muscles bilaterally secondary to pain.

Click here to continue. Challenge yourself by writing down a broad differential diagnosis before moving to the next slide.

NOTE: For more information, please contact the AMSSM, 4000 W. 114th Street, Suite 100, Leawood, KS 66211 (913) 327-1415.

© The American Medical Society for Sports Medicine
4000 W. 114th Street, Suite 100
Leawood, KS 66211
Phone: 913.327.1415

Website created by the computer geek