Back and Spinal Cord Disease

Differential diagnosis of back pain

  • Musculoskeletal: involving spine (vertebra, facet joints), paraspinal muscles and ligaments, sacroiliac joint, or hip joint. Spondylolisthesis, vertebral fx, OA, inflam. spondyloarthritis (RA, ankylosing spondylitis, reactive, psoriatic), musculoligamentous “strain,” myofascial pain syndrome, trochanteric bursitis.
  • Spinal cord (myelopathy)/nerve root (radiculopathy):
    • Degenerative/traumatic: disc herniation, foraminal or lumbar stenosis, spondylolisthesis
    • Neoplastic: lung, breast, prostate, RCC, thyroid, colon, multiple myeloma, lymphoma
    • Infectious: osteomyelitis/discitis, epidural abscess, zoster, Lyme, CMV, HIV, spinal TB
  • Referred pain from visceral disease:
    • GI: PUD, cholelithiasis, pancreatitis, pancreatic cancer
    • GU: pyelonephritis, nephrolithiasis, uterine or ovarian cancer, salpingitis