Back and Neck Pain
Back pain is a very common condition affecting a large number of the population. These patients commonly present to the emergency department with a first presentation or an acute on chronic exacerbation. One of the most important things to identify is whether the patient is suffering with back pain alone or whether there is a neurological component. In the initial investigation of these patients one must always consider a number of differential diagnoses to ensure potentially serious conditions are not missed.
Metastatic disease is the most common form of malignant bone disease. It can arise from a number of primary sites and can spread to bone via a number of mechanisms. Watch the video on metastatic bone lesions. The Mirels' score is used to classify the likelihood of impending fracture. Follow to link to see the paper on this classification system.
Lumbar Spine Pathology
Spinal disease causes a great deal of morbidity and indeed mortality. There any many conditions which can affect the spine and at undergraduate level only a relatively basic knowledge is needed.
Cervical Spine Pathology
Disease of the cervical spine is less common than in the lumbar spine but the consequences of neural compressive lesions are greater. Cervical cord compression can progress to myelopathy which in turn can lead to paralysis in the most extreme cases.