Skip to content

Differential diagnosis of a patient referred to physical therapy with low back pain: abdominal aortic aneurysm

by F Mechelli, Z Preboski, W G Boissonnault
The Journal of orthopaedic and sports physical therapy ()
Get full text at journal


STUDY DESIGN: Resident's case problem. BACKGROUND: A 38-year-old man with a history of chronic episodic low back pain (LBP) was referred to physical therapy by his physician. DIAGNOSIS: Concerns ascertained from the patient's history included an insidious onset of unrelenting, deep, boring pain that was constant, irrespective of movements or posture changes, or time of day. In addition, the patient reported night pain and the inability to find relief in recumbent positions. The primary warning signs associated with the physical examination were unremarkable examination of the lumbar spine, pelvis, and hip regions (symptoms not altered and minimal impairments detected), and a strong nontender, palpable pulse noted over the left lateral lumbar region, with the patient prone, and over the midline and left upper/lower abdominal quadrants, with the patient supine. Suspicion of the presence of an abdominal aortic aneurysm led the therapist to immediately refer the patient to an allopathic physician. The subsequent abdominal ultrasound and computed tomography scanning revealed a 10-cm-diameter abdominal aortic aneurysm. The patient was immediately hospitalized and underwent surgical repair within two days. DISCUSSION: LBP is the most frequent condition for patients seeking care from physical therapists in outpatient settings. The challenge for clinicians is to recognize patients in whom LBP may be related to underlying pathological conditions. A prompt referral of patients presenting with suspicious findings to the appropriate physician may lead to a more timely diagnosis, with the goal of minimizing or preventing morbidity and mortality.

Cite this document (BETA)

Readership Statistics

1 Reader on Mendeley
by Discipline
100% Medicine and Dentistry
by Academic Status
100% Student > Bachelor
by Country
100% Andorra

Sign up today - FREE

Mendeley saves you time finding and organizing research. Learn more

  • All your research in one place
  • Add and import papers easily
  • Access it anywhere, anytime

Start using Mendeley in seconds!

Sign up & Download

Already have an account? Sign in