Block Introduction/Differential Diagnosis of Spinal Conditions

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  1. Possible Serious Spine Pathology: Red Flags
    • TraumaticĀ 
    • Neoplastic
    • Infectious
    • Inflammatory
  2. Spinal tumors can beĀ ruled out if the patient is:
    • > 50 years old
    • No general health changes (i.e. unexplained weight loss)
    • No h/o CA
    • Responding to conservative intervention
  3. Postural Syndrome
    • Normal tissues abnormally strained for a period of time
    • SR requires a time element, usually at least several minutes in the abnormal position
  4. Dysfunction Syndrome
    • Tissues are tight
    • SR occurs only at end range of the tight tissue
  5. Derangement Syndrome
    • The normal alignment of the articular surface is disrupted
    • SR occur at multiple points throughout the range
    • Centralization & peripheralization of symptoms only occur in a derangement
  6. Non-Organic Signs
    • Distraction: significant decrease in pain behavior when patient is unaware they are being observed
    • Regional disturbances: weakness/sensory loss that does not conform to neuroanatomical explanation
    • Simulation: sham provocation tests cause pain despite not stressing tissues
    • Tenderness: in a non-anatomic pattern
    • Over-reaction: to provoked pain
Card Set
Block Introduction/Differential Diagnosis of Spinal Conditions
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