Back pain in the elderly.

Back pain in the elderly is a complex chief complaint, because numerous life-threatening or disabling conditions may present with signs and symptoms similar to those of more benign disease processes. An understanding of the limitations of physical examination and history distinguishing dangerous from benign causes is essential to avoid misdiagnosis and patient morbidity or mortality. This article describes the presentation and evaluation of dangerous causes of back pain, including vascular catastrophes, spinal cord compression syndromes, and infectious diseases. Less emergent musculoskeletal injuries are discussed briefly.

Non-operative management of a high-pressure water injection injury to the hand.

High-pressure injection injuries to the hand are work-related injuries that can take a devastating toll on the functionality of the affected extremity. Chemical injections are a surgical emergency. Injuries involving only water injection are rarer and have variable management strategies. We report a case of high-pressure injection hand injury due to water only. The patient was managed non-operatively with parenteral antibiotics, narcotics and elevation, with good outcome. We present a review of the literature on high-pressure injection injury.