Medical Quiz: Images Vol 10(1)

Medical Quiz Medical quiz: images Kundu Na, Rahim MAb, Ananna MAb, Chowdhury TAc (BIRDEM Med J 2020; 10(1): 78 ) A 72-year-old man got admitted with insidious onset, non-radiating low back pain for 1 month. His pain used to exacerbate on movement and relieved by taking rest and pain-killers. There was no history of any precipitating trauma, accompanying night pain or morning stiffness, neither was any history of fever, weight loss or cough. He also had complaints of increased frequency of micturition and increased thirst for the same duration. He was also constipated. On examination, he was anaemic and dehydrated. There was tenderness over lumbar spines. Movement of spine was restricted in all directions due to pain. Systemic examinations revealed normal findings. He was investigated accordingly and x-ray lumbo-sacral spine and skull lateral view are here (Figure 1 & 2). Figure 2. X-ray skull lateral view Questions 1. What are the abnormal findings of x-ray lumbosacral spine and skull lateral view? Figure 1. X-ray lumbo-sacral spine antero-posterior and lateral view 2. What is the likely diagnosis? 3. What further investigations you want to do to establish the diagnosis? Author information a. Nabin Kundu, Resident Medical officer, Department of Nephrology, BIRDEM General Hospital, Dhaka, Bangladesh. b. Muhammad Abdur Rahim, Mehruba Alam Ananna, Associate Professor, Department of Nephrology, BIRDEM General Hospital, Dhaka, Bangladesh. c. Tufayel Ahmed Chowdhury, Registrar, Department of Nephrology, BIRDEM General Hospital, Dhaka, Bangladesh. Address of correspondence: Nabin Kundu, Resident Medical Officer, Department of Nephrology, BIRDEM General Hospital, Dhaka-1000, Bangladesh. Email: nabinkundu 1991@yahoo.com Received: August 30, 2019 Accepted: October 31, 2019