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A 35-year-old female presents for evaluation of new onset lumbar spine pain. Which of the following physical exam findings is indicative of an organic cause of low back pain symptoms?
Positive straight-leg raise with patient distraction
Pain with axial loading of the spine
Diffuse tenderness with palpation of the paraspinal lumbar musculature
Lower extremity numbness in a non-dermatomal pattern
Pain with simulated rotation of the lumbar spine
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A 29-year-old male reports a 2-day history of atraumatic low back pain. He denies constitutional symptoms. He denies any bowel or bladder difficulties and physical examination reveals full motor strength and sensation. No pathologic reflexes are detected. All of the following are appropriate at the initial visit EXCEPT?
Limited oral analgesia
Radiographs of lumbar spine
Schedule outpatient follow-up visit within 4 weeks
Early range of motion exercises
A 32-year-old manual laborer has work-related chronic musculoskeletal back pain for several years. Which of the following is the strongest negative predictor for a successful clinical outcome with non-operative treatment?
High Visual Analog Scale (VAS) scores prior to treatment
Type of occupation
HPI - Condition started back in 2005 with lower back pain which was treated conservatively and slightly improved. In 2009 the patient had progressive left hip pain. In 2012 pt was diagnosed to have stress fracture of left femoral neck and had percutaneous fixation of the neck. The patient had slight improvment of symptoms for a short period of time. Now the patient continues ot have bilateral hip pain and low back pain. Current radiographs show an incomplete fracture of the right femoral neck and L5 pars defect. Lab studies have been normal.
What do you think is the most likely cause of the patients current symptoms?