ABSTRACT
History A 23-year-old caucasian man presented to the accident and emergency department (A&E) with back pain. Usually fit and healthy, he has suffered from achy throbbing back pain for the last 6 months. Always in the same position in his lower back, it is there intermittently but has increased in frequency over the last 2 weeks. The pain is worse at night and it often wakes him from sleep. He denies any trauma, weight loss or symptoms related to his bladder or bowel movements.
