Exercise 1
Exercise 1
Exercise 1
Compare Maigne’s syndrome and osteoporotic compression fracture of at
the thoracolumbar junction
Maigne’s Syndrome
Exercise 2
Differential Diagnosis of LBP with Radiculopathy
Age 30 – 55 60 40 - 60
History Acute or recurrent Insidious onset of Insidious onset LBP
episodes. chronic with or w/o saddle
progressive LBP; anaesthesia,
more recent onset bowel/bladder
of LE symptoms. function changes,
acute or chronic LBP.
Pain pattern Pain and/ or LE symptoms Usually radiculopathy
numbness increase with bilateral – pain,
radiating to lumbar extension tingling, numbness,
unilateral LE and relieved by increased with
below the knee, flexion. flexion.
usually increased
with flexion.
Neuro Exam Sensory and/ or Sensory and Bilateral sensory
motor changes, motor changes. and/ or motor
diminished/ changes, diminished/
absent DTR absent reflexes,
unilateral. sensory and motor
changes S3-S4.
ROM Guarding/ Limited Pain and limited Guarded/Limited
extension
Other Tests SLR Treadmill SLR
Exercise 3
This exercise will require some investigation on your part
You are required to ask for any additional information in the Q&A moodle chat.
However, when you ask for more information you must identify specifically what
information you want and why (ie. What differential diagnoses are you
considering and what will the information provide to help you)
Case History
Mark, 12yom, presented to your office with his Mum. Mark’s mother explained
that he has been complaining of back pain for the past few weeks, maybe longer.
She is unaware of any particular injury that started this and Mark doesn’t recall
any specific injury either. She explains he is a typical boy, plays soccer and rides
at the mountain bike park a few times a week. She would consider him relatively
active but he does like his ‘devices’ when he’s allowed. Mark says the pain is
‘pretty sore’ sometimes, he guesses it is about 5/10 and when asked to indicate
where it is he runs his hand across the region of the thoracolumbar spine.
- Diagnosis
I would be looking into the possibility of patient suffering from
growing pains or the possibility of facet joint degeneration in
adolescent idiopathic scoliosis.
Exercise 4
Explain Peripheralisation and Centralisation as they apply to the clinical
presentation and treatment of LBP with radiculopathy
Exercise 5
Besides those examples provided in the lecture, what questions might you ask to
determine if a patient has signs and symptoms associated with Cauda Equina
Syndrome?
- Have you had any difficulty with bowel movements and passing
stools? Either easier or more difficult?
- Do you have any difficulty with urine retention?