Back Pain Back Pain Diagnosis and Imaging 2

Question 1

Which clinical finding differentiates a central disc herniation from a posterolateral herniation?

Accepted Answer

Bilateral leg symptoms and potential cauda equina signs

Answer

Unilateral radiculopathy

Answer

Localized back pain only

Answer

Positive FABER test

Question 2

Waddell's signs are used to identify which category of back pain presentation?

Accepted Answer

Non-organic or psychosocial factors

Answer

Inflammatory back pain

Answer

Neuropathic pain

Answer

Fracture-related pain

Question 3

On MRI, a Modic Type 1 change in vertebral endplates indicates which pathology?

Accepted Answer

Bone marrow edema and inflammation

Answer

Fat replacement of bone marrow

Answer

Sclerotic remodeling

Answer

Normal aging changes

Question 4

Which symptom pattern is most characteristic of lumbar spinal stenosis?

Accepted Answer

Neurogenic claudication — leg pain relieved by sitting or flexing forward

Answer

Sharp constant back pain at rest

Answer

Unilateral sciatica with coughing

Answer

Night pain waking from sleep

Question 5

Which dermatome is affected by an L4 nerve root lesion?

Accepted Answer

Medial lower leg and medial ankle

Answer

Lateral calf and dorsum of foot

Answer

Posterior thigh and calf

Answer

Lateral foot and small toe

Question 6

Which finding on history should raise suspicion for inflammatory back pain (e.g., ankylosing spondylitis) rather than mechanical back pain?

Accepted Answer

Morning stiffness lasting more than 1 hour and improvement with exercise

Answer

Pain relieved with rest and worse with activity

Answer

Acute onset after lifting

Answer

Pain localized to one side only