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Yi Lu, MD, PhD, and Douglas Salvador, MD, MPH; August 2019
A woman with a history of prior spine surgery presented to the emergency department with progressive low back pain. An MRI scan of T11–S1 showed lumbar degenerative joint disease and a small L5–S1 disc herniation. She was referred for physical therapy and prescribed muscle relaxant, non-steroidal anti-inflammatories, and pain relievers. Ten days later, she presented to a community hospital with fever, inability to walk, and numbness from the waist down. Her white blood cell count was greater than 30,000 and she was found to be in acute renal and liver failure. She was transferred to a neurosurgery service at an academic hospital when an MRI revealed a T6–T10 thoracic epidural abscess.
Journal Article > Study
Dubosh NM, Edlow JA, Lefton M, Pope JV. Diagnosis. 2015;2:21-28.
This retrospective chart review study examined diagnostic errors in neurological cases in an emergency department. The most common sources of error were clinician knowledge gaps, which accounted for nearly half of all identified mistakes, and cognitive slips. Radiology resident misreads were also frequently implicated in missed diagnoses.