Case 1
A 35-year-old, healthy White male is complaining of right-sided, low back pain for 1 day. The pain began suddenly after lifting a box weighting 35 lbs. at work. The pain radiates down the back of his leg to his right ankle. He has tried ibuprofen and ice without relief. His pain is an 8 out of 10 (with 0 being no pain and 10 being the worst pain). He denies bowel or bladder dysfunction, paresthesia, motor weakness, or fever.
Physical examination revealed a well-nourished adult male without any acute distress. Significant right paraspinal tenderness at L4–L5 was present with no midline tenderness. Straight leg raise was positive at 30° to the right lower extremity. Straight leg raise was negative to the left lower extremity. The remainder of musculoskeletal examination was unremarkable (e.g., deep tendon reflexes, strength, and sensation). Other systems examinations were unremarkable (e.g., heart, lungs, etc.).
Answer the following questions based on the Case 1.
Case 2
A 13-year-old male is complaining of mild recurrent bilateral anterior knee pain without fever, joint swelling, erythema, or limitation of ambulation for the past 3 months. He is accompanied by his mother.
Physical examination revealed a well-nourished adolescent male without any acute distress. Significant bilateral tenderness was noted when palpating the tibial tubercles, and extending his knees against resistance reproduced pain. The remainder of the musculoskeletal examination was unremarkable (e.g., deep tendon reflexes, strength, and sensation). Other systems examinations were unremarkable (e.g., heart, lungs, etc.).
Answer the following questions based on Case 2.