Back Pain in a Young Man

Ronald A. Seltzer, MD
JAMA. 1966;195(8):677-678. doi:10.1001/jama.1966.03100080117035.
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Dr. William J. Otto: An 18-year-old white boy entered the hospital complaining of back pain of seven months' duration. The pain was constant but was relieved by mild analgesics. It radiated into the left leg to the lateral malleolus. He was seen at another hospital four months previously where a myelogram was said to be normal. There was no history of trauma or sudden strain.

Physical examination revealed tenderness over the fourth lumbar vertebra posteriorly and limitation of straight-leg raising on the left. Results of neurological examination were normal. All laboratory findings were within normal limits.

Discussion  Dr. Jack R. Dreyfuss: There is a lucent area, 11 mm in diameter, located in the superior aspect of the left lamina of the fifth lumbar vertebra (Figure, left). A laminagram (Figure, right) shows a small zone of sclerosis surrounding the defect and a suggestion of a small area of increased density within


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