Back Pain Back Pain Diagnosis and Assessment 2 — Questions and Answers
Question 1: What is the diagnostic term for back pain with no identifiable structural cause?
- Radiculopathy
- Myelopathy
- Non-specific low back pain (Correct answer)
- Spondylopathy
Correct answer: Non-specific low back pain
Non-specific low back pain accounts for approximately 85% of low back pain cases where no definitive pathoanatomical diagnosis can be identified.
Question 2: Fever, unexplained weight loss, and night pain unrelieved by rest in a back pain patient suggest which red flag condition?
- Herniated disc
- Spinal infection or malignancy (Correct answer)
- Degenerative disc disease
- Piriformis syndrome
Correct answer: Spinal infection or malignancy
Constitutional symptoms like fever, weight loss, and night pain are red flags for spinal infection (discitis/osteomyelitis) or metastatic malignancy.
Question 3: Which dermatome is associated with L5 nerve root involvement?
- Big toe and dorsum of foot (Correct answer)
- Lateral foot and small toe
- Anterior thigh
- Medial calf
Correct answer: Big toe and dorsum of foot
The L5 dermatome covers the dorsum of the foot, big toe, and medial aspect of the lower leg; weakness of great toe extension is the key motor finding.
Question 4: The Visual Analog Scale (VAS) is primarily used to assess which component of back pain?
- Functional limitation
- Pain intensity (Correct answer)
- Depression and anxiety
- Range of motion
Correct answer: Pain intensity
The VAS is a 0-10 or 100mm line scale used to quantify subjective pain intensity, allowing tracking of pain over time.
Question 5: Which finding on lumbar X-ray is MOST specific for spinal instability?
- Osteophyte formation
- Disc space narrowing
- Dynamic translation >4mm on flexion-extension views (Correct answer)
- Endplate sclerosis
Correct answer: Dynamic translation >4mm on flexion-extension views
Flexion-extension radiographs showing >4mm of translation between vertebrae is the key radiographic indicator of segmental instability.
Question 6: Waddell signs are used to identify which factor in back pain evaluation?
- Nerve root tension
- Psychosocial or non-organic pain behavior (Correct answer)
- Spinal stenosis severity
- Disc degeneration grade
Correct answer: Psychosocial or non-organic pain behavior
Waddell signs are a cluster of five behavioral tests that suggest non-organic or psychosocial contributions to low back pain rather than purely structural pathology.
Back Pain Back Pain Diagnosis and Assessment 2
What is the diagnostic term for back pain with no identifiable structural cause?