A 60-year-old
woman visited the authors' clinic with
low back pain and
arthralgia. Her symptoms had occurred 6 months previously, and she was treated with an
epidural injection and a balloon
dilatation procedure based on the assumption of
spinal stenosis, but both
treatments were ineffective. Her
low back pain was aggravated, accompanied by
fever and
chills over a period of 4 months. As a result, she visited another
referral hospital and was diagnosed with infective
spondylitis associated with the invasive
procedure. Her symptoms improved with
antibiotics, but they recurred. When she visited our clinic, she still had continuous
low back pain and febrile senses.
Magnetic resonance imaging of her lumbar
spine revealed interspinous
bursitis, and 18 F-fluorodeoxyglucose
positron emission tomography showed multifocal synovial
inflammation. She was diagnosed with
polymyalgia rheumatica and
treatment was started on
prednisolone and
celecoxib. Her symptoms improved dramatically and the inflammatory markers normalized.