Superbowl Party That Broke Her Back

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Superbowl Party That Broke Her Back - Page #3

Lab Studies: ESR: 70 CRP: 2.6 WBC: 9.7 without neutrophilia CD4: 1084 HgbA1c: 6.3 Other Studies: XR Lumbar Spine: Case Photo #1 Endplate irregularity and cortical indistinctness at L5-S1, new from previous imaging. Differential includes discitis/osteomyelitis, which should be excluded. Acute to subacute fracture of the inferior aspect of L5 could also be considered. Progression of degenerative changes felt less likely given this appearance represents a change from recent comparison CT. Suggest clinical correlation with inflammatory markers and further evaluation with MRI lumbar spine with and without contrast. MRI Lumbar Spine w/wo contrast: Case Photo #2 Findings consistent with discitis/osteomyelitis at L5-S1, with notable endplate and disc edema. Right greater than left facet and periarticular edema and enhancement most notably at L4-5 and mildly at L5-S1, could be reactive in nature. No significant facet joint erosions to suggest septic facet joint. Consultations: Orthopedic Surgery Neurosurgery Infectious Disease Click here to continue. Challenge yourself by writing down a revised, working diagnosis before moving to the next slide.		Back
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