A Man With Stooped Posture and Mysterious Back and Neck Pain

Nirupam Prakash, MD, MBBS


November 19, 2020

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A 53-year-old man with a 5-year history of type-2 diabetes mellitus and hypertension presents to the outpatient department with progressively worsening backache and stiffness over the past 6 months. He describes initial mild back discomfort that progressed to continuous pain accompanied by limitation of forward and side-to-side bending. He now has difficulty with sitting cross-legged, stooping, and rising from bed without support. His degree of stiffness does not vary over the course of the day, but it is slightly relieved with movement.

He also reports 3 months of similar pain and stiffness involving his neck. He reports no history of a fall, significant trauma, unusual weight lifting, bone pain, or symptoms of extra-axial joint involvement. He also has no history of fever, rash, oral ulcerations, ocular symptoms, or urinary symptoms.


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