ChiroACCESS Article



Diagnostic Imaging Case Report: A 63-year-old female reports with low back pain



This information is provided to you for use in conjunction with your clinical judgment and the specific needs of the patient.

Jack Henry, DC, DACBR

  

Radiology Diagnostics, LLC



Published on

May 25, 2011

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Hello.  My name is Jack Henry, DC, DACBR.  I am Radiologist-in-Chief of Radiology Diagnostics, LLC, an industry leader of Chiropractic Radiology Services and Digitized Spinographic analyses.  All of our services are provided at no cost to doctor and  no/low cost to patients.

Selected cases will be presented for your evaluation.  The studies may or may not have abnormalities.  Use the arrow keys or the scroll bar to carefully evaluate the films.

Step 1:  Is the study abnormal or normal?

Step 2:  If the study is abnormal, what is your best diagnosis?

Step 3:  Which follow-up imaging option would be best?

Step 4:  Compare your results with the correct diagnosis.


HISTORY

A 63-year-old female reports with moderate to severe low back pain. The patient’s past medical history and physical exam findings were not provided at the time of reading.







FINDINGS

The study is of sub optimal quality due to patient body habitus and technical factors. There is a left rotatory convexity of the lumbar spine. A laminotomy defect is present within the mid and lower lumbar spine. Advanced degenerative changes are present throughout the L/S spine. It is not clear if the degenerative changes are related or independent to the surgical procedure. More troubling is the large abdominal aortic aneurysm measuring approximately 5.8 cm at the L3 level.


DISCUSSION

AAAs are relatively common in particular patient populations. Attendings must understand that not all back pain is mechanical.


FOLLOW UP PROTOCOL

A CT and/or US evaluation is recommended as a base line follow-up.

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