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Updated: Jan 24, 2026
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Epidural and Paraspinal Abscess Presenting as Acute Low Back Pain
Summary
A primary care physician misdiagnosed a patient
Area of Science:
- Orthopedic Surgery
- Diagnostic Imaging
- Infectious Disease
Background:
- Acute lumbar pain following heavy lifting can mimic common musculoskeletal injuries.
- Primary care physicians (PCPs) may encounter patients with severe spinal conditions.
- Timely diagnosis is crucial for effective management of spinal infections.
Observation:
- A 56-year-old man presented with acute lumbar pain after lifting a heavy box.
- Initial diagnosis by PCP was lumbar disc herniation, with referral to physical therapy.
- Red flag symptoms prompted transfer to the emergency department for further evaluation.
Findings:
- Magnetic resonance imaging (MRI) revealed a spinal epidural abscess.
- A multiloculated abscess was also identified in the adjacent left paraspinal muscles.
- The patient's condition was more severe than initially suspected.
Implications:
- This case highlights the importance of recognizing red flag symptoms in patients with back pain.
- Over-reliance on clinical diagnosis without imaging can delay critical interventions.
- Prompt diagnosis and treatment of spinal epidural abscess are essential to prevent serious complications.
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