The Importance Of Diagnosis Bias: A Less Known But Common Cause Of Leg Weakness

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The Importance Of Diagnosis Bias: A Less Known But Common Cause Of Leg Weakness - Page #3

Lab Studies: CBC and CMP unremarkable Folate normal, B12 elevated Last available lab in May 2018, TSH 1.72 TSH 172.4, T4 < 3 Other Studies: Lumbar Spine X Ray Case Photo #1 Spinal alignment is maintained. Vertebral body heights are normal. Endplates are intact. Multilevel mild degenerative endplate changes and small marginal osteophytes with mild intervertebral disc height loss. Facet arthropathy between L3-L4 and L5-S1. Lumbar MRI Case Photo #2 Case Photo #3 Degenerative changes noted in the lumbar spine most prominent at L4-5. There is mild disc bulge and small left paracentral disc protrusion at L4-5 causing left lateral recess stenosis and effacement of traversing left L5 nerve root. There is mild right and moderate to severe left foraminal stenosis and minimal spinal canal narrowing at L4-5. Thoracic spine MRI and repeat Lumbosacral MRI both unremarkable. Consultations: Neurosurgery was consulted who recommended additional thoracic spine MRI and repeat lumbar spine MRI with admission for observation and pain control. Additionally, they requested MRI of the brain and cervical spine once those studies were largely unremarkable. Fortunately, those studies were able to be cancelled once a working diagnosis was discovered. Click here to continue. Challenge yourself by writing down a revised, working diagnosis before moving to the next slide.		Back
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