Case #2

Student details , SANTU SAHA , 
IQCMC , Durgapur , India
Class - General Medicine ward ( 3rd semester )

Age              : 74 years
Sex               : Male
Occupation : retired 

State             : West bengal
Year              : 2016

Chief complains
1. Pain in loin region 
2. Radiating pain towards Right lateral thigh from gluteal region
3. Loss of appetite

History of present illness

1. Onset : Two weeks ago, the pain became intense
2. Position : lower loin region 
3. Quality : continuous deep pain
4. Relieving or aggravating factors : pain aggravated when he moved forward or tried to bent
5. Severity : intolerable 
6. Timing : mainly during morning hours
7. Treatment : pain relieving injection received

History of past illness

1. Recent minor trauma in left hip joint
2. Gall bladder calculi also found , but not removed yet
3. Heart related disease

Family history 
His mother had  Spondyloarthropathy.

Confirmatory test : Schober's test also performed (17cm)

Diagnosis

# X- ray report suggests that there are osteophytes in LV1-5 and a typical bamboo shaped vertebral arrangement is also present
# Disc degenerative changes also , found at this level .

# Also , there is reduced size of sacroiliac joint parts .

# Lumbar lordosis reduced too.

All these findings suggests,  Spondyloarthropathy , ankylosing spondylitis.