Diagnostic pitfalls
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Diagnostic Pitfalls. Cancer and metastasis of the spine can mimic degenerative back and neck pain Early referral and early and wider use of MRI scans is essential to avoid missing serious pathology High Index of suspicion vital. Always ask history of previous malignancy

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Diagnostic Pitfalls

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Diagnostic pitfalls

Diagnostic Pitfalls

  • Cancer and metastasis of the spine can mimic degenerative back and neck pain

  • Early referral and early and wider use of MRI scans is essential to avoid missing serious pathology

  • High Index of suspicion vital. Always ask history of previous malignancy

  • 20% have no history of a primary malignancy


Pc f 62

PC. F=62.

  • C/o LBPx 6 months

  • Progressively worse

  • Radiates to left hip and thigh area

  • No red flags

  • Pain increased on sitting an walking

  • Still at work


Pc f 621

PC. F=62

  • O/E: Tender Left L3-5 area

  • SLR on left +ve at 60 degrees

  • Left SI joint tender

  • Reduced sensation left leg


Pc xrays

PC. Xrays.

Narrowing L45 Disc space

Early OA in Left Hip

Rx- Physio, Pain killers, Exercise programs

Not settling


Pc mri scans

PC. MRI Scans

Metastasis at T5, T8 and

L1, with bulging at T5.

? Left Hip pain referred from L1 area

No known Primary

Treated by radiotherapy.


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