Acute and chronic infections of the spine

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QUESTION 1 OF 2

83. A 45-year-old is referred by the medical team. Having presented 3 days ago with a 48hr history of fever, low back pain, mild bilateral leg pain but no urinary symptoms. On admission he had a CRP of 250 and blood cultures were taken with no growth currently. The medical team commenced antibiotics on admission and arranged a whole spine MRI scan, the salient lumbar aspects of which are shown in Figure 1. Reviewing him you note he has a temperature of 38.0 and normal power L2-S1 and altered sensation in L4-S1 bilaterally. A post-micturition bladder scan is 25ml. His CRP today is 245.
The most appropriate action at this time is:

Fig 8.13 Medium.jpeg

QUESTION ID: 3209

1. Change to broader spectrum antimicrobials.
2. CT chest/abdomen/pelvis
3. Echocardiogram
4. Open spinal decompression/drainage and sampling
5. Spinal decompression/drainage and sampling with instrumented fusion
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QUESTION 2 OF 2

69.A 12-year-old girl presents with a painless 30-degree thoracic curve. She is Risser grade 1. She only recently started her menses.
What would be your treatment recommendation?

QUESTION ID: 3220

1. Activity modification
2. Brace
3. MRI scan
4. Outpatient follow up in a year.
5. Spinal fusion
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