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Behind the Curve: Late-Onset Axial Spondyloarthritis

Published:October 03, 2018DOI:https://doi.org/10.1016/j.amjmed.2018.09.019
      The patient's diagnosis was more commonly associated with people in their teens and twenties. Yet, a 56-year-old woman met the criteria. Her primary care physician referred her to us after a 3-month history of neck and low back pain. The pain was sharp in nature, started from the posterior neck, and gradually involved the rest of the back. It persisted throughout the day and was worse with physical activity. She had associated morning stiffness, typically lasting 30 minutes to 1 hour. This was accompanied by generalized lethargy, poor appetite, and an unintentional weight loss of 2 kg (from 48 to 46 kg) over the same 3-month period. She had no weakness, numbness, night pain, fever, or night sweats and no history of trauma or falls. Despite her discomfort, she was still able to work and had some pain relief with oral acetaminophen. She had no significant prior medical history.

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