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High Priority Low Back Pain Questions

High Priority Low Back Pain Questions

A 68-year-old woman you last saw 9 months ago for a routine physical exam comes to see you complaining of low back pain that began about 1 week ago. She denies suffering any trauma to her back but reports that several weeks ago she felt a slight “tinge” when she lifted one of her bags while on vacation with her husband. Her only other current health problem is well-controlled hypertension. She does have a history of breast cancer 9 years ago, but she was successfully treated with chemotherapy.

Your physical exam reveals no abnormalities other than the patient complaining of a mild increase in pain when walking and bending over.

1. Based on the history and the exam, you should:

A.  Order a plain X-ray film of the lower back.

B.  Order an MRI of the back.

C.  Order a CT scan of the back.

D. Wait a few more weeks before ordering any further testing.

E. Refer the patient to a spine surgeon for evaluation.

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