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

Central herniations may compress multiple nerve roots and present with bilateral symptoms or cauda equina signs.

Question 2

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

Accepted Answer

Non-organic or psychosocial factors

Answer

Waddell's signs are physical exam findings that suggest psychosocial or non-organic contributors to back pain.

Question 3

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

Accepted Answer

Bone marrow edema and inflammation

Answer

Modic Type 1 changes represent bone marrow edema and inflammation at the vertebral endplate, often associated with active discogenic pain.

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

Neurogenic claudication presents as bilateral leg pain/weakness with walking that is relieved by sitting or forward flexion.

Question 5

Which dermatome is affected by an L4 nerve root lesion?

Accepted Answer

Medial lower leg and medial ankle

Answer

The L4 dermatome covers the medial lower leg and medial ankle region.

Back Pain Practice Test