55-Year-Old Man Who Presents with Long-standing Back and Hip Pain
Back pain is a common disorder, with nearly 80% of adults experiencing lower back pain over the course of their lifetime. In a majority of cases, back pain is caused by mechanical damage to the muscles, ligaments, discs, or bones. Arthritis is the most common cause of low back pain, especially in people over age 50. Axial spondyloarthritis (AxSpA) is a type of arthritis in which the primary symptom is back pain. Currently, the classification of AxSpA is dependent on presence of inflammatory back pain (IBP); it is diagnosed as ankylosing spondylitis (AS) if damage to the sacroiliac joints is evidenced by x-ray or as non-radiographic (nr-AxSpA) if damage is not present on x-ray. As there are distinct treatment options for mechanical back pain and IBP, making an accurate and timely diagnosis of the underlying cause of the back pain is critical to optimize patient outcomes.
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