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Random information from RX Q-bank (not that important)
**Anatomy of the vertebra**
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Clinical correlation
**Vertebral ligaments**
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Anatomical relations
Condition | Clinical clues |
---|---|
Degenerative (osteoarthritis) | ◦ Positional |
◦ Relieved with rest | |
Radiculopathy | |
(eg, disc herniation) | ◦ Radiates to leg |
◦ Sensory & motor findings | |
◦ Positive straight-leg raising test | |
Spinal stenosis | ◦ Pain with standing (spinal extension) |
◦ Relieved by spinal flexion | |
Spondyloarthropathy | ◦ Young men |
◦ HLA-B27 | |
◦ Relieved with exercise | |
◦ Prolonged morning stiffness | |
Spinal metastasis | ◦ Constant pain |
◦ Worse at night | |
◦ Not responsive to position changes | |
◦ Malignancies with a propensity for bony metastasis include Prostate, Breast, Kidney, Thyroid, and Lung (mnemonic: Pb KTL, or "lead kettle"). | |
◦ Prostate cancer is the most common malignancy in older men and frequently metastasizes to the axial skeleton and femur. | |
Vertebral osteomyelitis | ◦ Focal tenderness |
◦ Fevers & night sweats | |
◦ Recent infection, intravenous drug abuse, or immune compromise | |
Psychogenic | ◦ Evidence of secondary gain (eg, litigation/compensation) |
◦ unusual pattern of signs and symptoms can help identify these patients. | |
Pott disease | ◦ History of emigration from a tuberculosis-endemic region (far east Asia) |
◦ Progressive back pain, intermittent fever, and vertebral bone destruction with an adjacent fluid collection (abscess) |