2
give the rationale as to why you chose the diagnosis (es) over those prescribed by
iHuman.
For this iHuman assignment, I received full credit for the differential diagnosis listing. The
findings which led me to the
...
2
give the rationale as to why you chose the diagnosis (es) over those prescribed by
iHuman.
For this iHuman assignment, I received full credit for the differential diagnosis listing. The
findings which led me to the compression fracture differential were the patient has a current
diagnosis of osteoporosis, is a chronic smoker, drinks a glass of alcohol every day, and is on a
prednisone taper at the onset of an asthma exacerbation. Vertebral fractures are the most common
in those diagnosed with osteoporosis and present with associated pain upon moving.
Disk herniations tend to cause pain, numbness, and weakness in one or both lower
extremities. These herniations are more common at the L4 to L5 or L5 to S1. Ms. Jenkins stated
the associated continuous pain radiated from her lower back and down the right leg to below the
knee. Additionally, upon physical examination, the provider observed a positive straight leg raise
on both lower extremities, the right leg positive finding with contralateral leg raise, and right
lower extremity sensory and motor deficits. Lastly, Ms. Jenkin's pain occurred upon moving a
heavy table while at work. Disc herniations tend to happen when one does not utilize proper
body mechanics.
Ms. Jenkins and her history of osteoporosis, steroid use, chronic tobacco use, and research
led to placing spinal neoplasm as a differential. Although an unlikely cause of her acute lower
back pain and radiculopathy, a spinal neoplasm can manifest with similar presenting symptoms.
My differential diagnosis:
• Compression fracture
• Disk herniation
• Spinal neoplasm
• Rheumatoid arthritis
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