Respond to at least two of your colleagues on 2 different days who were assigned different case studies than you.

Respond to at least two of your colleagues on 2 different days who were assigned different case studies than you. Analyze the possible conditions from your colleagues\’ differential diagnoses. Determine which of the conditions you would reject and why. Identify the most likely condition, and justify your reasoning.
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Patient Information:

ZZ, Caucasian, Male, 42 y.o.

S.

CC: Lower Back Pain

HPI: ZZ is a 42-year-old Caucasian male presenting with pain in his lower back that radiates to his left leg for the past month. The pain is a stabbing and aching pain that is exacerbated by physical activity/walking and is relieved with rest, ice, and NSAIDs. The pain peaks at an 8/10 and limits his movement and mobility during flare-ups.

Current Medications:

Ibuprofen 800mg PO PRN Q8 hours for pain. Taking for past month around the clock.

Acetaminophen 650mg PO PRN Q8 hours. Taking for past month in between Ibuprofen doses for breakthrough pain.

Allergies: NKDA, No reported environmental or food allergies. Denies latex allergy.

PMHx: Denies surgical history or remarkable injuries/trauma. Pt reports all immunizations are current and cannot recall his last tetanus. Pt denies comorbid conditions.

Soc Hx: Denies alcohol or tobacco use currently. Pt reports using chewing tobacco in his teenage and early 20’s. Works as an accountant, has worked a desk job his entire adult life. Recently began cross-fit as a hobby with some of his work friends. Lives at home with his wife. Smoke alarms in every room. Always wears his seatbelt when driving or riding in a car.

Fam Hx: Mother: DMII, Father: Died in a skiing accident. Remaining first-degree relatives and offspring do not have any genetically correlated medical conditions.
Differential Diagnoses:

Sciatica
Sciatica manifests as acute back pain with radiculopathy that can extend to the lower extremities, such as the LLE as is the case with this patient (Dains et al., 2019, p. 350). Paravertebral tenderness is often observed in a sciatic patient like it was in this patient. Sciatica is often seen in patients that have experienced a strain or trauma and this patient has just recently begun to do cross-fit which can be the source of strains and trauma (p. 350). Sciatica also often results in a positive SLR test as there is often L4 nerve root irritation, which this patient exhibited also (p. 350).
Musculoskeletal Strain
The differential diagnosis of a musculoskeletal strain encompasses a wide variety of non-descript lower back and generalized back pain. It is often seen in patients that are participating in a new activity, such as the CrossFit that this patient is engaging in (Dains et al., 2019, p. 351). There is pain in the buttocks, back, and paravertebral tenderness that exists in two of the three manifestations in this patient.
Spinal Stenosis
Pain in spinal stenosis is worse throughout the day and can be aggravated by standing and relieved with sitting and rest (Dains et al., 2019, p. 351). Patient with spinal stenosis often experience pseudoclaudication, which is leg pain that results from compression of the cauda equina during spinal canal narrowing (Sherelud, 2019). The leg pain that this patient is experiencing could be a result of spinal stenosis and cauda equina compression but would require and MRI to confirm the diagnosis.

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Herniated Disc
A herniated disc can manifest in lower back pain that radiates down the buttocks to below the knee (Dains et al., 2019, p. 350). This patient is experiencing LBP that radiates to his leg intermittently. The symptoms of a herniated disc often present and are diagnosed in less than a month’s time and this patient is right on the cusp of that time frame, thus making it a worthwhile diagnosis to follow up with (p. 350). A patient with a herniated disc has a positive SLR test, which this patient does also. An MRI would be necessary to confirm this diagnosis.

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Psychological Back Pain:
Depression and other psychological issues can exacerbate minor pains and exaggerate the reporting and expression of pain (Dains et al., 2019, p. 352). This patient reported in his ROS that he has experienced intermittent depressed mood and depressive episodes for a while. Although he has never been officially diagnosed, his depression could be aggravating his back pain and making it worse than it is. This would require ruling out other diagnoses prior to accepting this diagnosis as the origin of his ALBP.

SAMPLE SOLUTION

Week 8 Discussion Response
The discussion presented for assessment centers around patient ZZ who is Caucasian male aged 42 years. The patient’s chief complaint is having a lower back pain. The history of the illness is that the pain has been radiating to the left leg for the past one month. The other characteristic is that the pain is stabbing and aching and gets intense with physical activities like walking (Rau & Chai, 2020). The patient is also relieved by resting, using ice as well as NSAIDs. Due to a high pain intensity, the patient s unable to | PLACE YOUR ORDER NOW AT writtask.com | the objective and subjective assessment, the discussion presents five conditions to be depicted in the differential diagnosis. The first condition is Sciatica which is a condition that manifests itself as an acute back pain with radiculopathy and…