Lower back pain, management.

47 years old patient. suffering from low back pain

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Bridging osteophytes in lumbar spine Narrowing of sacroiliac joints Diffuse idiopathic skeletal hyperostosis a possibility Rule out ankylosing spondylitis CBC esr RA factor HLA B27 typing Clinically assess chest expansion Spine flexion

Loss of Lumbar lordosis, paraspinal muscle spasm Calcification of anterior inter spinal ligaments , bridging Osteophytes Degenrative spondylosis of lumbar spine To investigate to rule out AS MRI , HLA typing suggested

Presence of multiple syndesmophytes and age points towards ankylosing Spondylitis. Check for chest expansion,cervical xray,hla b27 Since syndesmophytes are only on anterior side,DISH(forestiers disease) is another possibility.

Osteophytes L4L5 Lateral ligaments calcified ANKYLOSING SPONDYLITIS lumbar spondylitis

Osteophyttes L3 4 5 Ankylosing spondylitis

Tnx sir

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Bridging osteophytes Disc space is clearly visible with endplates ? DISH

Bridging osteophytes in lumbar spine . RA ?


Physiotheray treatment is.... Hot fomentation Tens Back extension exercise Back strenthening exercise

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