QqqqqQ(Self made question46) - sweety_usmle

[ArchivalUser]

A 47 years old male come to your clinic with complains of two day history of severe low back pain. He says that he has had similar problems for years but this time it is more severe. His complain consists of pain radiating to buttock and tight leg. His vitals are T:98F, P:88bpm, BP:110/80 mm of Hg, RR: 12. On examinations there is rigidity to the lumbar spine. When you attempt to apply pressure on paravertenral region in the lower lumbar spine, pain is noted. Lasegue sign is positive. The achilles tendon reflux is reduced. Which of the following is the appropriate next step in management?

A. Surgical Consultaion
B. MRI vertebral column
C. NSAIDs and two day bed rest
D. X-Ray lumbosacral spine
E. Radionuclide bone scan

[ArchivalUser]

C. this is a herniated disk with lasegue sign being the same thing as straight leg test and with pain radiating down. so you give nsaids and rest and if doesnt get better, only then do an MRI.

Thanks!

[ArchivalUser]

although they do usually recommend early mobilization bc that helps the patient get better faster.

[ArchivalUser]

C.....??

[ArchivalUser]

C.....??

[ArchivalUser]

C. But Exercise/ Yoga/ Returning to normal activities is superior to Bed rest
Disk herniation (Sciatica):
Decreased reflexed
Lasegue positive


Also, if no improvement then give steroids

[ArchivalUser]

Answer "C"

Yes, light exercise is better than bed rest but the option says 2 days which is not bad either. More than 2 days is not ok.

Hope this was helpful

[ArchivalUser]

hi sweety thanks a lot for these fabulous questios
in acute low back pain (acc to usmle world) if there red flags or sciatica (as in this pt) we first do back x-ray and ESR ?? please explain??? thank you