Chronic low back pain differential diagnosis

Chronic low back pain differential diagnosis includes

1. degenerative conditions

a) degenerative spondylolisthesis

b) lumbar spinal stenosis

c) lateral recess syndrome

2. spondyloarthropathies

a) ankylosing spondylitis:look for erosive changes adjacent to SI joint and positive test for HLA- B27 antigen

b) Paget’s disease of the spine: vertebral involvement is very common in a patients with Paget’s disease

3. osteitis condensans ilii: increased density in ilium, usually asymptomatic (incidental) finding. Occasionally may produce low back pain or tenderness. Usually found in women who have been pregnant

4. psychological overlay: including secondary gain (financial, emotional…)