Differential diagnosis of low back pain

Mechanical low back pain

Lumbar strain

Degenerative disease

Discs (spondylosis)
Facet joints (osteoarthritis)

Spondylolisthesis

Herniated disc

Spinal stenosis

Osteoporosis

Fractures

Congenital disease

Severe kyphosis
Severe scoliosis
Possible type II or type IV transitional vertebra*

Possible spondylolysis

Possible facet joint asymmetry

Nonmechanical spine disease

Neoplasia

Multiple myeloma
Metastatic carcinoma
Lymphoma and leukemia
Spinal cord tumors
Retroperitoneal tumors

Infection

Osteomyelitis
Septic discitis
Paraspinous abscess
Epidural abscess

Inflammatory arthritis (often HLA-B27-associated)

Ankylosing spondylitis
Psoriatic spondylitis
Reactive arthritis
Inflammatory bowel disease

Scheuermann disease (osteochondrosis)

Paget disease

Visceral disease

Pelvic organs

Prostatitis
Endometriosis
Chronic pelvic inflammatory disease

Renal disease

Nephrolithiasis
Pyelonephritis
Perinephric abscess

Aortic aneurysm

Gastrointestinal disease

Pancreatitis
Cholecystitis
Penetrating ulcer

Fat herniation of lumbar space

HLA: human leukocyte antigen.
* A transitional vertebra is a congenital anomaly in which there is a naturally occurring articulation or bony fusion between the transverse processes of L5 and the sacrum, but there is still a small remnant disc space between L5 and the sacrum. Type II means that one or both transverse processes appear to form a diarthrodial joint with the sacrum, but there is no bony fusion. Type IV means that there is a type II abnormality on one side and a complete bony fusion on the opposite side.

Graphic 60679 Version 11.0

خرید پکیج

Differential diagnosis of low back pain