An 18 year-old girl, with a 2 year history of recurrent low back pain secondary to sports-related injuries, presents following her most recent injury, in which she was struck in the back while playing basketball. She saw a local alternative medicine practitioner for acute exacerbation of that pain following this injury and was given a prescription for cyclobenzaprine and NSAIDs. Several weeks later while getting ready for school she collapsed due to pain and was taken to the ED.
The patient noticed some mild fatigue and a weight loss of 2.5kg weight loss, but denied any history of fevers, chills, night sweats or any recent illnesses. Physical examination Back ROM limited by pain, full LE ROM with only minimal discomfort, mild swelling left of L4/L5 with point tenderness over those vertebrae. More pain with palpation of soft tissue on right with increased paraspinal muscle tone there.…
