A Man With Stooped Posture and Mysterious Back and Neck Pain

Nirupam Prakash, MD, MBBS

Disclosures

November 19, 2020

Editor's Note: The Case Challenge series includes difficult-to-diagnose conditions, some of which are not frequently encountered by most clinicians but are nonetheless important to accurately recognize. Test your diagnostic and treatment skills using the following patient scenario and corresponding questions. If you have a case that you would like to suggest for a future Case Challenge, please contact us.

Background

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.

Comments

3090D553-9492-4563-8681-AD288FA52ACE
Comments on Medscape are moderated and should be professional in tone and on topic. You must declare any conflicts of interest related to your comments and responses. Please see our Commenting Guide for further information. We reserve the right to remove posts at our sole discretion.
Post as:

processing....