Back pain

This chapter presents a case study of 63-year-old man presented to the emergency department (ED) with a chief complaint of "low back pain". It focuses on the clinical presentation, diagnosis, and treatment of select life-threatening emergencies in elderly patients with acute back pain. Computed tomography (CT) with intravenous contrast has become the diagnostic study of choice to confirm aortic dissection (AD). The ED management of elderly patients with AD centers on control of the heart rate and blood pressure. Laboratory evaluation of the older adult patient with suspected vertebral osteomyelitis (VOM) often includes a complete blood count, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), and blood cultures. The ED treatment of patients with VOM centers on antibiotic therapy and consultation with either neurosurgery or orthopedic surgery. Spinal cord compression from metastatic malignancies is a back pain emergency that must be diagnosed promptly to prevent further disability and death.