Medical history A 69-year-old female patient reports abdominal and lumbar high-intense piercing pain with radiation to the medial and the lateral face of the lower limbs, exacerbated with a passive mobilization of the limb that started about one month ago. In use of ciprofloxacin for treatment of urinary tract infection. At examination: preserved general condition, afebrile, hemodynamically stable, muscle strength in limbs quantified in 4 (0-5) by Medical Research Council (MRC) scale and allodynia in the soles of the feet. CRP: 249 mg / dL. Image 1: Magnetic resonance imaging (MRI) of the thoracolumbar spine, sagittal T1, without contrast. Image 2: MRI of the thoracolumbar spine, sagittal T1 FAT, with intravenous contrast (gadolinium). Image 3: MRI of the thoracolumbar spine, sagittal T2. Image 4: MRI of the spine in the segment comprised between T12-L4. Axial T2 (upper) and axial T1 FAT (lower). Question:According to the case and the exposed images, the probable diagnosis is: a) Complicated pyelonephritis b) Pyogenic spondylodiscitis c) Pott's disease (vertebral tuberculosis) d) Age-compatible degeneration of L1 and L2 vertebrae Test question Secretary of State for Health - ES (SESA / ES) 2013. Center for Selection and Promotion of UnB Events (CESPE) In relation to low back pain, one of the pathologies that most incapacitate the individuals of economically active age, mark the correct option. a) For patients with unilateral lumbar pain radiating to the ipsilateral flank, urinary symptoms, fever and pain to lumbar percussion, the main diagnostic hypothesis is infectious or septic discitis. b) Most episodes of low back pain are limited and have muscular origin (mechanical or idiopathic low back pain). c) Pain in the spine is always related to inflammatory rheumatism. d) Arthrosis of the spine reach only the elderly. e) Most patients with low back pain due to disc herniation present symptoms of medullary compression and pain that evolves with sphincter dysfunction and paraparesis. Time is Up! Time's up
