49 year old otherwise healthy asian woman involved in work related trauma at a wearhouse with a fall onto the backside. Developed minimal superior end plate compression dx and slight distal coccyx fracture. Injury sustained in march. Patient complains of significant lumbosacral pain and difficulty with sitting and transitional movements,
Also complains of constant pressure sensation in pelvic area like feeling the need to defecate and sharp discomfort prompting trips to the bathroom but no bowel movements.
MRI reveals healed L1 fracture, no instability, minimal facet dz lower lumbar. No disc herniation.
X-ray of coccyx with small nondisplaed distal coccyx fx.
She is very sensitive to palpation lower lumbar paraspinals and coccyx. Neuro intact.
Doesn’t seem crazy. Hard working Asian immigrant woman, tearful, came in with her whole family.
Can’t figure out the constant pressure sensation and need to defecate.
I ordered a pelvic mri and intra articular facets for her seemingly mechanical lower back pain.
Thoughts?
Also complains of constant pressure sensation in pelvic area like feeling the need to defecate and sharp discomfort prompting trips to the bathroom but no bowel movements.
MRI reveals healed L1 fracture, no instability, minimal facet dz lower lumbar. No disc herniation.
X-ray of coccyx with small nondisplaed distal coccyx fx.
She is very sensitive to palpation lower lumbar paraspinals and coccyx. Neuro intact.
Doesn’t seem crazy. Hard working Asian immigrant woman, tearful, came in with her whole family.
Can’t figure out the constant pressure sensation and need to defecate.
I ordered a pelvic mri and intra articular facets for her seemingly mechanical lower back pain.
Thoughts?