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Lombalgia: Um diagnóstico diferencial raro

Authors: Silva, Miguel Tadeu Reis e;

Lombalgia: Um diagnóstico diferencial raro

Abstract

Apresenta-se o caso de uma doente internada no Serviço de Medicina Interna com os diagnósticos principais de Traqueobronquite aguda a descompensar Insuficiência Cardíaca de base. À observação, para além do quadro respiratório/cardiovascular, a doente apresenta queixas álgicas lombares referidas a L1-L4, presentes mesmo em repouso, Murphy renal negativo e Lasègue negativo bilateralmente. Após revisão das radiografias lombares realizadas em internamento, é detetada imagem de contornos calcificados, sacular e localizada anteriormente aos discos vertebrais de L3-L4. Pela presença concomitante de abdómen pulsátil e diminuição dos pulsos periféricos dos membros inferiores, é pedida AngioTAC com o intuito de despistar provável Aneurisma da Aorta abdominal. O mesmo exame confirma a presença de volumoso Aneurisma abdominal que condiciona fluxo arterial numa das artérias renais, com consequente atrofia. We present a case of a patient admited in an Internal Medicine ward with the main diagnosis of an acute bronchitis and heart failure. At the observation, the patient referred pain to the L1-L4 area, that wasn’t relieved by rest, a negative renal Murphy and a negative bilateral Lasègue. During the review of the lumbar radiographs, it was detected a sacular figure of calcified borders, before the L3-L4 vertebrae. By the concomitante presence of a pulsatile abdómen and a decrease of the peripheric pulse in the inferior members, the medical team ordered an AngioCT to despite a possible Abdominal aortic aneurysm(AAA) . The exam confirmed a bulky AAA that impaired the arterial flux to the left renal artery.

Keywords

lombalgia, aneurysm, Low back pain, aneurisma

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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
0
Average
Average
Average
Green