A summary of the safety diagnostic model is presented in Table 34.1 Table 34.1 Thoracic back pain: diagnostic strategy model
Q. Probability diagnosis
A. Musculoligamentous strains (mainly postural) vertebral dysfunction Q. Serious disorders not to be missed
• dissecting aneurysm
• pulmonary infarction Neoplasia
A • lung (with infiltration) A. • metastatic disease Severe infections
• infectious endocarditis
• osteomyelitis Pneumothorax Osteoporosis
Q. Pitfalls (often missed)
• oesophageal dysfunction
• peptic ulcer (penetrating)
• pancreatic A. Herpes zoster
Spondyloarthropathies Fibromyalgia syndrome Polymyalgia rheumatica Chronic infection
Q. Seven masquerades checklist
Spinal dysfunction xx
Q. Is this patient trying to tell me something?
A. Yes, quite possible with many cases of back pain.
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