A young patient has back pain and tightness with a dull ache that improves during the day and worsens at night. There is no history of trauma, no tenderness, and a negative straight leg test. What is the diagnosis?

a) Lumbar strain
b) Herniated disc
c) Ankylosing spondylitis
d) Degenerative disc disease

Question

10-10-2024
Medicine

College

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A young patient has back pain and tightness with a dull ache that improves during the day and worsens at night. There is no history of trauma, no tenderness, and a negative straight leg test. What is the diagnosis?

a) Lumbar strain
b) Herniated disc
c) Ankylosing spondylitis
d) Degenerative disc disease

Answer :

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soniabalmiki295 soniabalmiki295 · Answer 1 · 2024-06-15T15:25:25-04:00

Final answer:

Based on the description of symptoms and the negative straight leg test, the diagnosis for the young patient's condition aligns with Ankylosing spondylitis, given the characteristic worsening of symptoms at night and improvement with activity, without evidence of trauma or localized tenderness.

Explanation:

The young patient's symptoms of back pain and tightness, which improve during the day but worsen at night without any preceding trauma or tenderness, and a negative straight leg test, point towards a diagnosis of Ankylosing spondylitis (AS). This condition typically lacks the acute onset associated with herniated discs or the physical trauma often linked to lumbar strain. Additionally, the absence of rapid degenerative changes or localized tenderness that would be characteristic of degenerative disc disease further supports AS as the most likely diagnosis. Ankylosing spondylitis is characterized by its chronic course and its tendency to cause stiffness and pain in the axial skeleton, particularly noticeable in the mornings and at night with improvement upon activity. The patient's presentation closely aligns with the symptomatic pattern of worsening symptoms at rest and nocturnal pain, typical of AS.