12-01-2010, 03:44 PM
A 22 year old man with history of chronic backache presents to your office. The patient has a history of progressive low back pain for 3 years. He relates his pain to a motor vehicle accident that happened to him 3 years ago. X-rays of the spine were performed three years ago at the start of his symptoms and were normal. He reports that his pain is worst in the morning but gradually improves towards the end of the day. The patient has been using over the counter ibuprofen and tylenol with out any relief. He was recently started by his primary care doctor on oxycodone which he takes 6 times daily as needed for pain. This did not relieve his pain either. The patient is here to see you for a second opinion. The most appropriate next step in management is :
A. Plain X-ray of lumbar spine and pelvis
B. MRI of the lumbar spine
C. Prescribe long acting narcotic
D. Physical Therapy
E. HLAB27 testing
A. Plain X-ray of lumbar spine and pelvis
B. MRI of the lumbar spine
C. Prescribe long acting narcotic
D. Physical Therapy
E. HLAB27 testing