Clin Osteol 2025; 30(3): 161-166

Differential diagnostics of back painReview articles

Richard Chaloupka, Luděk Ryba

Klinika ortopedie a spondylochirurgie, LF MU a FN Brno

Diagnostics of back pain consists of several levels - history, subjective, objective examination, imaging methods, laboratory tests, internal and neurological examinations. Each level has to be evaluated, and all levels have to be compared and concluded. In imaging methods we start with X-rays, anteroposterior and lateral. CT examination is indicated in skeletal pathology (especially in injuries). MRI is indicated in neural deficit, suspicion of inflammation and tumours, bone scan in suspicion of metastatic lesions. Laboratory tests: ESR, CRP, blood count help us in infections and internal examination. After diagnosis of affected level (vertebra, disc) we specify pathoanatomical etiology - congenital anomalies, tumours, inflammation, degenerative conditions, injuries. According to the affected tissue we can diagnose discogenic, vertebrogenic, neurogenic, vascular, psychogenic, pain projection from internal organs. According to the level and etiology of lesion we plan treatment. In injuries with severe neural deficit we perform surgery up to 6 hours after injury, in tumours and inflammation up to 24 hours after onset of severe neural deficit - palsy or plegia.

Keywords: back pain, diagnostics, etiology.

Published: September 1, 2025  Show citation