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The Rational Clinical Examination
David L. Simel, Drummond Rennie
Low Back Pain
Ben Stern, Richard A. Deyo, James Rainville, Richard S. Bedlack
Make the Diagnosis: Low Back Pain


Topics Discussed: back pain, criterion standard comparisons (diagnostic tests), fractures, compression, herniated disc, low back pain, lower back, make the diagnosis, prior probability, radiculopathy, spinal neoplasms

Excerpt: "Because of the weak associations among symptoms, physical findings, imaging results, and electromyograms, a majority of patients with low back pain ( 85%) cannot be given a definitive diagnosis. Among asymptomatic individuals, 20% to 30% have evidence of a herniated disk on computed tomography (CT) or MRI. However, only small portions (2%) of individuals with low back pain eventually undergo surgery for disk herniation. Thus, the prevalence of clinically important disk herniations is low...."
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