Table of Contents
Common Questions
Chat with CodyMD
Cody's Chat with Patient
Cody's AI Summary
Top 3 AI Diagnosis List
Review by Dr Albert DiPiero
Dr. DiPiero Video Guide to this Case Study
Resource Center
Testimonials
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Case Study
Meet your host
Albert DiPiero, MD MPH FACP
I am a co-founder and the Chief Medical Officer at CodyMD and your host for this edition of Cody Grand Rounds. I have been a practicing physician and faculty member at medical schools for over 26 years.
About The AI Doctor Case Study
CodyMD is a partnership between Human Doctors and AI Doctors. Cody is an AI Doctor who helps thousands of people every day. At each Cody Grand Rounds, I select a real case and review it with Cody, the AI Doctor.
Each case is based on a real patient but has been modified to maintain privacy and to emphasize certain teaching points.
Common Questions
What are the common causes of lower back pain?
When should I see a doctor for lower back pain?
What is sciatica and how is it treated?
How can I prevent lower back pain?
Is surgery necessary for a herniated disc?
What are the symptoms of degenerative disc disease?
Can lower back pain be managed with home remedies?
Chat with CodyMD
Click the button below to initiate a conversation with CodyMD, your AI Doctor.
Cody's Chat with Patient
Below is a conversation transcript between the patient and our AI Doctor CodyMd.
Cody, the AI Doctor
What is your health issue today?
Patient
Lower back pain.
Cody, the AI Doctor
Good to meet you. My goal is to provide you with an accurate assessment and plan. Let's talk about your concerns regarding lower back pain. Can you describe the location and intensity of your lower back pain?
Patient
Right lower back and sharp ache down legs
Cody, the AI Doctor
Sharp lower back pain that radiates down the legs can be a sign of sciatica, which is caused by compression of the sciatic nerve. When did you first start experiencing lower back pain?
Patient
4 days ago
Cody, the AI Doctor
Have you been diagnosed by a health professional with any medical conditions?
Patient
No
Cody, the AI Doctor
What is your gender and year of birth?
Patient
1992, male
Cody, the AI Doctor
Is your lower back pain getting worse, getting better, staying the same, or does it vary day to day?
Patient
Stays the same
Cody, the AI Doctor
Do you have any fever, weakness in the legs, tingling in the legs?
Patient
No, none of these.
Cody, the AI Doctor
How did your lower back pain start?
Patient
Suddenly when I woke up one morning
Cody, the AI Doctor
On a scale of 1 to 10, how would you rate the severity of your lower back pain?
Patient
About an 8.
Cody, the AI Doctor
Have you noticed any specific activities or positions that make your lower back pain better or worse?
Patient
Sitting and standing both hurt.
Cody's AI Summary
- You are a 32-year-old man with low back pain radiating down your legs.
- Pain started 4 days ago.
- You have not been diagnosed with any medical conditions that could contribute to your lower back pain.
- Your lower back pain is staying the same and is rated as an 8 on a scale of 1 to 10 in terms of severity.
- Your lower back pain started suddenly one morning when you woke up.
- Sitting and standing both worsen your lower back pain.
Top 3 AI Diagnosis List
Based on the information and conversations with Cody, we have prepared a top 3 AI Diagnosis List.
1. Lumbar herniated disc(60 % probability)
A condition where the inner core of the disc in the spine herniates or leaks out, causing lower back pain that radiates down the legs.
2. Sciatica(30 % probability)
A condition characterized by pain that radiates along the path of the sciatic nerve, often caused by compression of the nerve roots in the lower back.
3. Degenerative disc disease(10 % probability)
A condition where the intervertebral discs in the spine degenerate, leading to lower back pain and possibly leg pain.
Review by Dr Albert DiPiero
Dr. Albert DiPiero
In reviewing the patient’s history and symptoms, I am reminded by how lower back pain is a multifaceted issue that can stem from various conditions such as herniated discs, sciatica, or degenerative disc disease. In the case of our 32-year-old male patient experiencing severe pain rated at 8/10, the most likely diagnoses include a lumbar herniated disc and sciatica, given the sudden onset of sharp radiating pain exacerbated by both sitting and standing. While less probable, degenerative disc disease remains a possibility.
1. Lumbar Herniated Disc(55% probability)
Given the sudden onset of the sharp, radiating pain and exacerbation with sitting and standing, a lumbar herniated disc tops our differential.
2. Sciatica(40% probability)
The classical presentation of pain radiating down the legs supports sciatica, often linked with lumbar disc issues.
3. Degenerative Disc Disease(5% probability)
Though less likely at 10%, the chronic nature of degenerative disc disease can contribute to similar symptoms.
Next Steps for Evaluation
Physical Examination: A thorough physical exam to evaluate for signs of nerve impingement or muscular involvement.
MRI or CT Scan: These imaging studies would confirm the presence of a herniated disc or other spinal anomalies. But these are not needed in the first 4 to 6 weeks while conservative management is implemented, unless the patient experiences worsening of symptoms, especially weakness, worsening sensory changes, or change in bowel or bladder function.
Potential Treatment Modalities
Conservative Management: Remaining active, using non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen, and implementing physical therapy, heat and massage are all parts of the first line approach to low back pain.
Interventional Procedures: Epidural steroid injections if conservative treatments fail.
Surgical Options: Surgical consultation for decompression if there is no improvement with other therapies or if there is significant neurologic compromise.
Dr. DiPiero Video Guide to this Case Study
Resource Center
Testimonials
I appreciate the fact that there is no charge after telling him my issues. I also like the quick responses with absolutely no judgment of any kind.
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