Hello!, Practical class and Master class members!
Welcome back to our tutorial series on interpreting simple radiographs for musculoskeletal and spinal pain.
In today's session, we will use a case study to apply what we've learned about interpreting radiographs based on the ABCs rule: Alignment, Bone density, and Cartilage space.
Here's a brief patient history and simple lumbar spine radiographs. Your task is to apply the ABCs rule to these radiographs, considering the patient's symptoms and history.
Our patient is a 45-year-old male who works as the head of courier service at our hospital, a physically demanding job. He first noticed mild lower back pain a few weeks ago, which has since evolved into persistent numbness in his left foot, especially during prolonged walking. Standing still is particularly uncomfortable for him, but he reports less pain while lifting and moving objects - a routine part of his job.
The patient recently saw a neurologist and underwent X-rays and a CT scan, which suggested nerve compression. He attempted physical therapy once following the diagnosis.
His symptoms include tingling extending from his left gluteal region to the posterior thigh and tightness in his right lower back.
Now, take a look at the radiographs.
Analyze the alignment, looking for any irregularity in the shape of the vertebral bodies and any alterations at different levels. Evaluate the bone density for any changes in each vertebra's density. And finally, assess the cartilage spaces - is there any narrowing or widening? Can you determine if this is an instability or stabilizing phase?
What is your interpretation based on your analysis of the radiographs and the patient's symptoms?
Can you identify the potential problem visible on the X-ray, and can you describe the possible pathology?
What might be causing the patient's symptoms?
Can you make any predictions about the patient's prognosis?
What findings do you anticipate in an MRI scan?
I will soon share the MRI findings with you, so stay tuned! It is an excellent opportunity for you to test your interpretation skills. Let's see how your analysis matches up with the MRI results. Thank you for your participation, and see you next time!
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26 авг 2024