Question

A 20 year old patient presenting with chronic low backache and early morning stiffness since last 2 years. Since 6 months there are bilateral heel pain also. Most likely diagnosis for this patient is –

• A. TB spine
• B. Ankylosing spondylitis
• C. Mechanical pain
• D. Disc prolapsed

Answer 1

The Correct Option is B

The patient, a 20-year-old, is experiencing chronic low backache and early morning stiffness for the past two years. Additionally, there is bilateral heel pain that started 6 months ago. These symptoms are characteristic of a specific medical condition.

To determine the most likely diagnosis, let's analyze the symptoms:

• Chronic Low Backache and Stiffness: Long-lasting back pain with stiffness, especially noticed in the morning, is indicative of inflammatory back conditions.
• Age: The patient is relatively young, at 20 years old, which is a common age of onset for certain arthritic conditions.
• Bilateral Heel Pain: This can be associated with enthesitis, which is inflammation of the sites where tendons or ligaments insert into the bone.

With these points in mind, let's evaluate the provided options:

1. TB Spine: Typically presents with localized spinal pain and may have systemic symptoms like fever or weight loss.
2. Ankylosing Spondylitis: Often begins in young adults, characterized by chronic back pain, morning stiffness, and enthesitis (such as heel pain).
3. Mechanical Pain: Generally worsens with activity and improves with rest; lacks inflammatory signs like morning stiffness.
4. Disc Prolapsed: Manifests with localized back pain and possibly radiculopathy, but not typically with systemic symptoms like stiffness.

The most fitting diagnosis, given the age, symptoms of early morning stiffness, chronic low back pain, and bilateral heel pain, is Ankylosing Spondylitis.