Author: Adrian Boyle / Editor: Adrian Boyle / Reviewer: Michael Perry, Rafeeq Ahmed Sulaiman / Codes: IC2, MuC5, MuC7, SLO1, SLO3 / Published: 21/08/2023
A 25-year-old man has attended the Emergency Department (ED) four times in the last fortnight with low back pain. The man tells you that there is no history of trauma. The pain has been progressing over the last three weeks and he feels generally ill. He has not lost any weight. He injects heroin.
On examination he is unkempt and uncomfortable. He is thin. He is tender over the lower lumbar spine and his neurological examination of his legs is normal. Rectal examination reveals normal anal tone and intact perianal sensation.
14 responses
Good learning topic. I have never come across discitis during my clinical career. After reading this module I am confident that I will be able to spot discitis and manage it appropriately.
Common case
Unhappy patients
Most expect MRI scan by ED
Main cause of opioid abuse
Good case / Good revision
Good to know about discitis
Good topic as a very common presentation in emergency department
Good topic.
good topic
the importance of careful examination of the reattenders and low threshold to further investigate, rolling out serious underlying conditions
Simple but very informative, thanks.
good case
Not uncommon presentation in ed.
This was an interesting case. Only come across it once before clinically. A good revision around the risk factors for discitis.
To be mindful of red flags in back pain
Never seen a case of discitis so far but quite confident will be able to manage one. Very useful learning …