Real Case: Was I being an alarmist GP looking for zebras? Not this time

My patient has a bad back. Sometimes he gets a bout of sciatica. It usually gets better after a week of prednisone.

Over a three-day weekend, he went to ED twice.

The first time he got a shot of an NSAID that did little for his pain. The second time he got X-rays, some basic lab work, a prescription for prednisone and an urgent message for me to order an updated MRI as soon as possible. That message reached me late morning.

I called him to see how he was doing.

He was still in a great deal of pain, and his leg had