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Postgraduate Medical Journal 2002;78:373
© 2002 The Fellowship of Postgraduate Medicine

SELF ASSESSMENT QUESTION

Back pain

Back pain and systemic compromise

A A Dyer , K Ashkan , J Norris

Department of Neurosurgery, Hurstwood Park Neurological Centre, Haywards Heath, West Sussex, UK

Correspondence to:
Correspondence:
Mr K Ashkan, Department of Neurosurgery, Level 3, Southwood Building, Great Ormond Street Hospital for Children NHS Trust, Great Ormond Street, London WC1N 3JH, UK

Submitted 30 November 2001
Accepted 24 January 2002

Answers on p 377.

Keywords: epidural abscess; lumbar disc prolapse

The first 150 words of the full text of this article appear below.

A 30 year old white man presented to his local hospital with a four day history of lower back pain and leg weakness after a minor fall. His past medical history included a lumbar microdiscectomy eight years before. He was not diabetic and there were no risk factors for immunosuppression. Initial examination showed normal power and reflexes in both legs but there was decreased sensation on the inner aspect of the left calf, scrotum, and perianal area with normal continence. While awaiting investigation he developed an absent left ankle reflex. Magnetic resonance imaging (MRI) of the lumbar spine was then performed (see fig 1Go), on the basis of which he was referred to the regional neurosurgical unit.


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  		Figure 1 T2 weighted sagittal MRI scan of the lumbar spine.

 
On arrival, the patient was unwell, markedly tachycardic at rest, and dehydrated with severe tenderness in the lumbar spine. Neurological examination . . . [Full text of this article]


Relevant Article

Back pain and systemic compromise
Postgrad. Med. J. 2002 78: 377. [Extract] [Full Text] [PDF]





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