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