Diagnostic Tests for Middle back pain

Diagnostic Test list for Middle back pain:

The list of diagnostic tests mentioned in various sources as used in the diagnosis of Middle back pain includes:

• General inspection
  • Posture, gait, level of distress
• Physical examination
  • Blood pressure (ruptured aortic aneurysm may cause back pain with low blood pressure)
  • Inspect the middle back for symmetry and any deformities (kyphosis or scoliosis)
  • Palpation of the back (centrally and laterally) to reproduce the pain
  • Examine range of movement of the middle back to reproduce pain
• Blood tests
  • Full blood count and ESR
  • Calcium, phosphate and alkaline phosphatase
  • Prostatic specific antigen (PSA) in males if appropriate
  • HLA-B27 antigen test for Ankylosing Spondylitis and Reiter's disease (uncommonly cause problems in the middle back)
  • Serum electrophoresis for Multiple myeloma
  • Brucella agglutination test (for Brucellosis)
  • Blood culture (for vertebral osteomyelitis and bacterial endocarditis)
• Mantoux test - if suspect Skeletal tuberculosis.
• Urine tests
  • Bence -Jones protein analysis for Multiple myeloma
• Radiological investigations
  • X-Ray of spine - can detect arthritis changes, fractures, reduced bone mass, reduced bone height and malignancy.
  • CT or MRI of spine - perform if the person has persistent back pain. Can detect spinal canal stenosis or nerve root compression.
  • Bone scan - can detect the early development of malignant disease, osteomyelitis and inflammatory disease before changes are apparent on plain X-Ray.
  • Bone densitometry - can predict an increased risk of osteoporosis.
• Electrocardiogram (ECG) - to rule out suspected angina chest pain.
• Gastroscopy or Barium studies (to rule out possible peptic ulcer)

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