Table 331 Major causes of low back leg pain presenting in the authors general practice

Patients %

Vertebral dysfunction 71.8

Lumbar spondylosis 10.1

Depression 3.0

Urinary tract infection 2.2

Spondylolisthesis 2.0

Spondyloarthropathies 1.9

Musculoligamentous strains/tears 1.2

Malignant disease 0.8

Arterial occlusive disease 0.6

Other 6.4

100.0

Relevant causes are illustrated in Figure 33.1

\Ziseeral and vascular

S —biliary disorders U— penetrating duodenal ulcer ft—pancreatitis ft—renal disorders aoftic aneurysm (ruptureil/dlssectinfll netropentoneal haemorrhage female pelvic disorders e.g. endometriosis prostatitis —"

abscess, e.g. pilonidal arterial embolism--*

clauc cj:ion of arter jI occlus ve disease -

\Ziseeral and vascular

S —biliary disorders U— penetrating duodenal ulcer ft—pancreatitis ft—renal disorders aoftic aneurysm (ruptureil/dlssectinfll netropentoneal haemorrhage female pelvic disorders e.g. endometriosis prostatitis —"

arterial embolism--*

clauc cj:ion of arter jI occlus ve disease -

Musculoskeletal

Scheuermann's d sen der patholog cal fracture metastatic d ssase spondylolisthesis disc disruption facet jomt dysfunction spondylosis sacroiliac dysfuncticn saeroiliitis trochantenc bursitis gluteus medius bursitis v coccydynia

""ischial bursitis rneraigia paraesthetica neurogenic claudkattwi

__.—— radicular pain \ from referred pain / dysfunction radicular pain

Fig. 33.1 Relevant causes of back pain with associated buttock and leg pain

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