Back pain
COVID-19 clinical presentation
<div class="redbox">
<p style="text-size:12px;">COVID-19 can present with a myriad of symptoms so should probably be on most differential diagnosis lists during the pandemic</p>
<li><a href="https://productivemedic.com/covid-remote-assessment/" target="_blank">COVID assessment, DDx and complications</a></li>
<li><a href="https://www.google.com/imgres?imgurl=https%3A%2F%2Ff6publishing.blob.core.windows.net%2F2ab0884c-0618-4586-aaf1-41004e6ad656%2FWJCC-8-3956-g002.png&imgrefurl=https%3A%2F%2Fwww.wjgnet.com%2F2307-8960%2Ffull%2Fv8%2Fi18%2F3956.htm&tbnid=I0G0VvXcx_akPM&vet=12ahUKEwj1_43FsrnuAhUH-YUKHSoZAFQQMygYegUIARCwAQ..i&docid=IBDQMbzRItpvKM&w=3307&h=2168&q=covid%2019%20presentation&safe=strict&ved=2ahUKEwj1_43FsrnuAhUH-YUKHSoZAFQQMygYegUIARCwAQ" target="_blank">Clinical presentation summary infographic</a></li>
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*Common causes
*Must not miss!
- Cauda Equina Syndrome
- Spinal cord compression
- Malignancy
- Infections
- Referred pain
*Easily missed
Red flags
- Cauda equina syndrome
- Bilateral Sciatica
- Saddle anaesthesia
- Bladder or bowel dysfunction
- Major motor weakness
- Gait problems (e.g. foot drop)
- Thoracic pain
- Major recent trauma (RTA, fall from a height)
- Minor trauma or lifting in people with Osteoporosis
- Age >50 years or <20 years
- History of Cancer, HIV, Drug abuse
- Constant, progressive or night pain disturbing sleep
- Systemic symptoms (fever, night sweat, weight loss)
- Immunosuppression (HIV, Chemotherapy, Steroids)
Investigations to consider
- FBC, CRP/ESR
- U&Es, LFTs, Bone profile
- Auto antibody screen
- Myeloma screen
- PSA
- Urinalysis
- X-ray Spine
- MRI scan
- Bone scan
- CXR, CT chest, abdomen & pelvis