| Objective: To report the case of a 73-year-old male with low back pain presenting to a chiropractic teaching clinic in whom an abdominal aortic aneurysm (AAA) was fortuitously found on plain film radiography. Clinical Features: The patient presented with a 3-week history of sudden onset low back pain of minimal-to-moderate severity, which he attributed to walking. The physical examination findings, including an unremarkable abdominal examination, suggested a diagnosis of acute mechanical low back pain. Plain film radiographs demonstrated an AAA measuring 8.5 cm in transverse diameter. In a retrospective file review, clinical risk factors for AAA were present. Intervention and Outcome: The patient was referred to his general medical practitioner and subsequently to a vascular surgeon. He underwent surgical repair with Dacron graft prosthesis. His back pain resolved the day after surgery. Conclusion: AAA may present as low back pain, and thus it is important to actively exclude the condition in ‘at risk’ patients. Risk factors include male patients 65 years and older presenting with abdominal and/or low back pain, a significant smoking history, increased weight, cardiovascular disease, vascular claudication, chronic obstructive airway disease, and a first degree relative with AAA. Patients at risk need urgent referral for appropriate imaging and/or vascular surgical opinion. This abstract is reproduced with the permission of the publisher; full text (print only) by subscription.
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