Articles: back-pain.
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Der Urologe. Ausg. A · Jul 1996
Case Reports[Left-sided flank pain in coincident infrarenal aortic aneurysm and left-sided nephropathy].
Two cases illustrating the difficult differential diagnosis of left-sided pain in the coincidence of nephropathy and aortic aneurysm are described. In both cases an aortic aneurysm was discovered, although the aneurysm caused the pain in the side in only one case. In particular, older men with recently occurring side or back pain must be examined with regard to aortic aneurysm. As the classic symptoms of a ruptured aneurysm are frequently disguised, aneurysm must always be considered as a cause of left-sided pain.
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Bone SPECT imaging offers advantages over planar techniques based on improved contrast enhancement plus tomographic effect, with the latter allowing for precise anatomic localization of an abnormality. This is important when evaluating patients with back pain because placement of a lesion in the vertebral body, component of the vertebral arch, or disc space region significantly affects diagnostic possibilities and, in some circumstances, can effectively exclude malignancy in favor of benign disease. Such an approach to SPECT interpretation requires high-quality images capable of precise anatomic placement of a lesion and a systematic method of analysis based on recognition of normal anatomic relationships plus knowledge of the common presentations of bony abnormalities shown on SPECT scanning.
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Randomized Controlled Trial Clinical Trial
Prospective study of the incidence of transient radicular irritation in patients undergoing spinal anesthesia.
There is considerable controversy regarding the role of subarachnoid 5% hyperbaric lidocaine in the syndrome transient radicular irritation (TRI). This randomized, double-blinded, prospective study was designed to determine the incidence of TRI and identify factors possibly contributing to its development. ⋯ The incidence of TRI is greater with lidocaine than bupivacaine, decreasing the lidocaine concentration to 2% does not prevent TRI, and surgical position may be an important contributing factor. Discharge times at our institution are not different when equipotent doses of 0.75% hyperbaric bupivacaine or 5% hyperbaric lidocaine with 0.2 mg epinephrine are used in ambulatory patients undergoing spinal anesthesia.
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Randomized Controlled Trial Clinical Trial
Long term backache after childbirth: prospective search for causative factors.
To assess in a prospective randomised study the association between motor block resulting from high and low dose epidural infusions of bupivacaine in labour and the incidence of long term backache after childbirth, and to compare the incidence of backache in women not receiving epidural analgesia. ⋯ The incidence of new long term backache was not significantly increased in women who received epidural analgesia in labour. Motor block resulting from epidural local anaesthetic administration was not a significant factor in the development of backache.