V. Treatment: A. Vascular – require emergent surgical consults. AAA rupture 30 day survival rate 11% in some series. While waiting for consult, control hypertension (beta blocker + vasodilator) if present.
B. Spinal cord compression (due to malignancy, infection such as epidural abscess, herniated disc/cauda equina syndrome, hematoma): emergent diagnostic imaging – MRI or CT with myelogram, emergent orthopedic or neurosurgical consult, add IV steroids if due to malignancy, antibiotics if infectious.
C. Osteomyelitis without any neurologic deficits – blood cultures/esr/crp/cbc, MRI, arrange biopsy, hold antibiotics only if clinically stable until after biopsy, then start empiric coverage based on risk factors for particular pathogens.