This is a very short letter published in 2004 in The British Journal of General Practice signed by Peter Curtis just because he retires and wants to share certain thoughts about the intellectual capital and wisdom of the senior doctors. He explains about the clinical entity back mice.
Treasures in the attic
The British Journal of General Practice. 2004;54(503):473.
He titled the letter TREASURES IN THE ATTIC, in reference to his medical knowledge during years of being a doctor and the legacy he can leave behind.
Of all these treasures he finds worth mentioning what he calls “his own clinical pearl”: the “back mouse or back mice”.
The ‘clinical pearls’ are pearls of knowledge that are traditionally presented by selected members in certain medical schools at an annual medical student fest known as “The Pearl Day”. These pearls are rarely based on solid research evidence but still much loved and appreciated.
Peter Curtis “clinical pearl” are the back mice
He warns that the knwoledge of these lumbar nodules can be MOST REWARDING, avoiding the often prolonged quest for painkillers and surgery.
He states that back mice are a RELATIVELY COMMON PRIMARY CARE PROBLEM, which had been and STILL IS OVERLOOKED by most clinicians and medical teachers.
He writes small notes about back mouse or back mice:
-The back mouse is a FIBRO-FATTY nodule (often more than one) found in 25% of the population.
-It usually hides in the deep subcutanous layers.
-The back mice can produce LOCAL ACUTE back pain or CHRONIC back pain, but also REFERRED PAIN and tingling to such areas as ankle, trochanteric bursa, knee, foot and anterior pelvis.
-This “sclerotomal referral pattern” causes that the doctors ascribe the symptoms to much more serious medical problems such as disc prolapse or arthritis. This leads to prolonged and costly testing, lorry loads of medications and even the THREAT OF DISC SURGERY.