Dunnick and Green Unit 6

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Imaging Unit 6 Assignment by Laura Dunnick and Chayla Green

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Baastrup’s Syndrome:

Baastrup’s Syndrome By Laura Dunnick and Chayla Green

Baastrup’s Syndrome:

Baastrup’s Syndrome What is it? “kissing spinous processes” 1 decreased joint space of adjacent spinous processes in the lumbar spine Cause: degeneration of interspinous ligament secondary to aging 2,3 supraspinous or infraspinous ligament sprain excessive lordosis 2

Baastrup’s Syndrome:

Baastrup’s Syndrome Signs and Symptoms: Excess lumbar lordosis Mid-line back pain 3 Flexion alleviates Extension aggravates Localized interspinous or spinous process pain with or without referral pattern 3 Risk factors: 2,3,4 Increasing age Extension biased sports (gymnastics, swimming, weight lifting) Patients with central spine stenosis or DDD Spondylolysthesis Obesity

Baastrup’s Syndrome:

Baastrup’s Syndrome Incidence: 1,2,3,4 Not specified for the general population Diagnosis: 2 Lateral Plain Radiographs MRI Bone Scanning with SPECT

Baastrup’s Syndrome:

Baastrup’s Syndrome Prognosis: still unknown Impact on function: Painful movement - extension, rotation, side bending Neurogenic claudication Self-limiting

Baastrup’s Syndrome:

Baastrup’s Syndrome Physical Therapy Management 3 - Modalities - Core stabilization - Soft tissue manipulation

Baastrup’s Syndrome:

Baastrup’s Syndrome Imaging for diagnosis and management 3,4 Plain film & CT—shows trademark “kissing spines” decreased joint space between adjacent spinous processes faceted appearance of spinous process presence of osteophytes on spinous processes MRI—shows fluid and soft tissue involvement interspinous bursal fluid compression of the posterior thecal sac postero-central epidural cysts

Baastrup’s Syndrome:

Baastrup’s Syndrome Increased lumbar lordosis 1 Decreased joint space between adjacent spinous processes 1,4 Osteophytes 3 Evidence of degenerative disc disease 4

Questions:

Questions You are treating a patient diagnosed with Baastrup’s disease. She is a 16 year old gymnast hoping to earn a gymnastics scholarship for college. Her activities require functional lordosis. How will this affect your treatment for return to function? You suspect a patient with LBP to have Baastrup’s Disease, and he is not responding to treatment after 8 weeks of therapy. What is your next plan of action?

References:

References El-Beialy M, AbouGazia A. Baastrups syndrome. Radiopedia . October 9 2013. Available at http://radiopaedia.org/cases/baastrup-syndrome-3. Accessed October 10, 2013. Baastrup’s disease (kissing spines disease). Spine and Sports Medicine of New York . 2010. Available at http://ssmny.com/?post_type=resources&p=202. Accessed October 10, 2013. Bourdinon S, Rommers N, Ceulemans L. Baastrup syndrome. Physiopedia . Available at http://www.physio-pedia.com/Baastrup_Syndrome. Accessed on October 10, 2013. Helgeson, K. Unit 3 - Lumbar spine. Imaging for physical therapy. 2013.

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