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Case of the week: Did I break my spine?

Posted on 19. Aug, 2013 by in Read

spinal fracture

 

Imagine this conversation:

Dr Joe: You have presented with neck pain, headaches, back pain, depression and anxiety. When I examined you, there is extreme pain when I touch around your mid to lower back. It has me concerned.

Patient: Yes, me too. Its been there for years. I am now 30 but I remember it being there since I was a child.

J: Lets get some plain x rays, come back this afternoon for a full report

P: OK

Patient comes back and I read the x rays. Looking at the shot above, I see a portion of the inferior-lateral margin of a middle thoracic vertebra missing. As it happens, her cervical spine shows signs of whiplash injury.

J: Mrs P this area here looks as if you have suffered an injury that has crushed the front part of your vertebra. Have you ever broken your spine, sagittarius weekly horoscope traits of being hard-working and concentrated help them gain success in virtually any endeavor, but the close the top is the more sagittarius weekly horoscope people want to do something new and unknown. or suffered a fracture? Its like you have folded your body in half?

P: what? (mild panic)

J: it certainly looks like you have fractured your spine.

(patient thinks, eyes welling up with tears, and then remembers)

P: Oh, God, years ago when I was about 10 I rolled and tumbled over in a go-kart. I have had pain in my back ever since. The worst thing is was that nobody believed me at the time. I begged to be taken to the doctor and ever since I have lived in pain.

J: Let me tell you one thing: you have been justified in your suffering and I am sorry that nobody believed you. This could have created ongoing anxiety and self doubt issues. Now you know why.

The

moral? Plain film x rays when properly used to confirm a diagnosis can not only ascertain prognosis, but can also be used to explain some yellow flags considered barriers to progress.

In addition, human beings are complex, and, often anxiety is not just an disorder without purpose.

Most importantly: children are to be believed, until reasonable doubt is gone.