Traumatic Onset of Acute Lower Back Pain with Emerging Abdominal Aortic Aneurysm (AAA): Case Report
To report a case of a 70-year-old white female, who presented with acute lower back pain (LBP) after a recent fall. This case highlights the importance of priorities in decision-making in clinical diagnosis and management and the need for coordinated spine care along medical specialties.
DISCUSSION: No immediate adverse events were recorded, and repeated follow-up imaging indicated no significant AAA expansion. Considering that mobilization causes similar displacement to active motion, research into the safety of MT in this population is warranted as are guidelines for appropriate initial and ongoing clinical screening during treatment in this population. PMID: 30198815 [PubMed - as supplied by publisher]
Discussion This resident's case problem provides an opportunity to discuss the differential diagnosis, clinical reasoning, and outcome of a patient who presented with both systemic and neuromusculoskeletal pathology. Level of Evidence Differential diagnosis, level 5. J Orthop Sports Phys Ther, Epub 6 Feb 2018. doi:10.2519/jospt.2018.7652. PMID: 29406836 [PubMed - as supplied by publisher]
Abstract: Chronic contained rupture of an abdominal aortic aneurysm with vertebral body erosion most commonly presents with symptoms of low back pain. Although not well known, vertebral body erosion or destruction may be seen in up to 25% of patients with sealed or contained rupture of an abdominal aortic aneurysm. This appearance on cross-sectional imaging may mimic a malignant or infectious process. Although these cases can present a diagnostic challenge, published cases of chronic contained rupture of an abdominal aortic aneurysm with vertebral body erosion demonstrate clinical and imaging similarities that, when recogn...
A man in his 60s underwent replacement of an artificial blood vessel for abdominal aortic aneurysm. After surgery, low back pain and elevated serum amylase level were noted. Post operative days (POD)5, he developed fever. He was diagnosed with catheter-related bloodstream infection ；antibiotic administration was initiated. POD 7, computed tomography (CT)showed severe acute pancreatitis and he was referred to us. His low back pain disappeared and amylase levels decreased. However, as his fever was prolonged, antibiotics were continuously administered.
74-year-old man presented with abdominal discomfort, low back pain and emaciation. Hematocrit and haemoglobin levels were 33 and 11 g/dL, respectively. Erythrocyte sedimentation rate was normal. Serological tests for rheumatic disorders were negative. Multidetector CT (MDCT) scan of the abdomen was performed to identify the cause of pain. At the level of T7 vertebra, thoracic aorta was measured 49 mm in diameter and at the level of T6-L1 vertebra, irregular aortic aneurysm was seen. Mural thrombus and calcified plaques of the thoracic aorta were seen.
A 74-year-old man presented with abdominal discomfort, low back pain, and emaciation. Hematocrit and hemoglobin levels were 33 and 11 g/dL, respectively. Erythrocyte sedimentation rate was normal. Serological tests for rheumatic disorders were negative. Multidetector computed tomography scan of the abdomen was performed to identify the cause of pain. At the level of T7 vertebra, thoracic aorta was measured 49 mm in diameter, and at the level of T6–L1 vertebra irregular aortic aneurysm was seen. Mural thrombus and calcified plaques of the thoracic aorta were seen.
Ruptured abdominal aortic aneurysm (rAAA) commonly presents as acute abdominal or lower back pain and hemodynamic instability. We discuss the case of a 90-years old patient who presented to the emergency unit with a three days history of left testicular pain. Ultrasound scan demonstrated and a computed tomography (CT) scan confirmed a 6cm in diameter rAAA with enlargement and hematoma of the left psoas muscle causing the symptoms. This atypical presentation highlights the need for clinical vigilance and emercency physicians-performed ultrasound scan in the older patients with seemingly benign testicular symptoms.
In this report, we describe a case of a 55-year-old male with Behçet’s disease who presented with a low back pain and sciatica. Imaging studies showed that he had a destruction of the third lumbar vertebra because of abdominal aortic aneurysm-related Behçet’s disease. Aortic aneurysms with vertebral body erosion have been rarely reported, but this vascular complication is a life-threatening clinical picture. Therefore, among the causes of chronic lumbar pain in a BD patient, abdominal aortic aneurysm should be remembered.