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Biomechanical Changes Related to Low Back Pain: An Innovative Tool for Movement Pattern Assessment and Treatment Evaluation in Rehabilitation

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Published on: December 13, 2024

A Case of Confounding Back Pain.

Cedric A Green¹, Lydia Mbatidde², Jehan R Shah¹

¹Department of Family Medicine, Mayo Clinic, Jacksonville, FL, USA.

The American Journal of Case Reports

|June 12, 2023

Summary

Acute back pain can signal serious conditions like vertebral osteomyelitis, especially with red flag symptoms. Early, thorough evaluation is crucial for timely diagnosis and effective treatment to prevent complications.

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Area of Science:

Internal Medicine
Infectious Diseases
Radiology

Background:

Acute back pain is highly prevalent in primary care, affecting over 60% of individuals.
Red flag signs like fever or neurological deficits necessitate further investigation.

Observation:

A 70-year-old male presented with midthoracic back pain post-hospitalization for sepsis due to multidrug-resistant Escherichia coli UTI.
Initial conservative management and radiography were unremarkable.
Persistent pain led to MRI, revealing T7-T8 osteomyelitis and discitis.

Findings:

CT-guided biopsy confirmed multidrug-resistant E. coli, indicating hematogenous spread from the urinary tract infection.
Treatment involved 8 weeks of intravenous ertapenem.

Implications:

This case underscores the importance of a broad differential diagnosis for back pain, even in primary care.
Maintaining vigilance for red flag symptoms and pursuing appropriate investigations are key for early detection of vertebral osteomyelitis.
Prompt management can prevent severe complications associated with spinal infections.