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The differential diagnosis of lumbar disorders

Possible differential diagnoses for lumbar disorders and conditions that may mimic them are listed below. Comprehensive information detailing each of these clinical presentations along with guidance for investigation, management and appropriate referral can be accessed in the supporting documents.

Mechanical lumbar disorders

Mechanical lumbar disorders include:

  • non-specific low back pain
    • degenerative processes of discs and facet joints (spondylosis)
    • lumbar strain
    • lumbar sprain
    • spondylolysis
    • spondylolisthesis
    • internal disc disruption
    • discogenic low back pain
    • osteoporotic compression fracture
    • congenital disease e.g. severe kyphosis/scoliosis
  • Radiculopathy
  • Spinal Claudication
  • Acute Cauda Equina Syndrome

Details on signs and symptoms, investigation methods, management recommendations and referral details for each of the above types of mechanical disorders are available in the Mechanical lumbar disorders (PDF 259KB) fact sheet.

Other spinal conditions

Other spinal conditions include:

  • Neoplasia
    • Multiple Myeloma
    • Metastatic Carcinoma
    • Lymphoma and Leukaemia
    • Spinal cord tumours
    • Retroperitoneal tumours
    • Primary vertebral tumours
  • infection
    • Osteomyelitis
    • Septic discitis
    • Paraspinous abscess
    • Epidural abscess
    • Shingles
  • inflammatory arthritis
    • Ankylosing Spondylitis
    • Psoriatic Spondylitis
    • Reiter’s Syndrome
  • Scheuermann’s Disease
  • Paget’s Disease of bone

Details on signs and symptoms, investigation methods, management recommendations and referral details for each of the above disorders are available in the Differential diagnoses - other spinal conditions (PDF 141KB) fact sheet.

Conditions that may mimic spinal disorders

  • Hip Osteoarthritis
  • Vascular Insufficiency
  • Diabetic Neuropathy
  • Sacroiliac Joint dysfunction
  • Visceral Disease
    • Disease of Pelvic Organ, for example, Prostatitis, Endometriosis or Pelvic Inflammatory Disease (PID)
    • Renal Disease, for example, Nephrolithiasis, Pyelonephritis or Perinephric abscess
    • Gastrointestinal Disease, for example, Pancreatitis, Cholecystitis, Penetrating Ulcer or Inflammatory Bowel Disease

Details on signs and symptoms, investigation methods, management recommendations and referral details for each of the above disorders are available in the Differential diagnoses - conditions that may mimic spinal disorders (PDF 312KB) fact sheet.

 

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