From the Publishers of

A Pain in the Back

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ACP Guideline Published in 2011

http://annals.org/article.aspx?articleid=746774
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Key Points

Back pain is very common A selective approach to back pain imaging

is recommended

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Indications for immediate imaging

Major risk factors for cancer as a cause Risk factors for spinal infection Evidence of cauda equina syndrome

Urinary retention Fecal incontinence

Saddle anesthesia

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Mr. G
Diabetic Boil 3 weeks ago Malaise Tenderness L3-L4

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Epidural abscess
Identifiable portal of entry in 2/3 Spinal surgery Epidural catheter Skin soft tissue infection Hematogenous (iv drug use) Classic: fever + spine tenderness + neurologic Most not classic MRI

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Consult Guys Replies

Mr. Gs presentation suggests epidural

abscess
An MRI should be done

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