Differential Diagnosis for 37 y/o Male with Chronic Low Back Pain and Spondylosis
- Single Most Likely Diagnosis
- Spondylosis with spondylolisthesis: This is the most likely diagnosis given the patient's symptoms and the radiographic findings of spondylosis. Spondylosis refers to a defect in the pars interarticularis, which can lead to spondylolisthesis, a condition where one vertebral body slips forward over another, causing chronic low back pain.
- Other Likely Diagnoses
- Degenerative disc disease: This condition is characterized by the wear and tear of the intervertebral discs, which can cause chronic low back pain and is often associated with spondylosis.
- Facet joint syndrome: The facet joints are small stabilizing joints located between and behind adjacent vertebrae. Inflammation or degeneration of these joints can cause chronic low back pain.
- Musculoskeletal strain: Chronic strain on the muscles and ligaments of the lower back can cause pain and is a common condition in individuals with spondylosis.
- Do Not Miss Diagnoses
- Spinal stenosis: A condition where the spinal canal narrows, putting pressure on the spinal cord and nerves. While less common, it's a serious condition that can cause significant pain and neurological symptoms.
- Cauda equina syndrome: A rare but serious condition where the nerves in the spinal canal are compressed, causing pain, numbness, and weakness in the legs, as well as bladder and bowel dysfunction.
- Infection (e.g., osteomyelitis, discitis): Infections of the spine can cause severe back pain and are a medical emergency.
- Tumor: Although rare, spinal tumors can cause back pain and are a critical diagnosis not to miss.
- Rare Diagnoses
- Ankylosing spondylitis: A type of arthritis that can cause the vertebrae to fuse together, leading to chronic back pain and stiffness.
- Spondylodiscitis: An infection of the intervertebral disc space, which can cause severe back pain and is often associated with fever and other systemic symptoms.
- Osteoporotic compression fracture: A fracture of the vertebral body due to osteoporosis, which can cause sudden onset of back pain.