Back pain and weight loss from a spine gone to Pott

A patient's pain and reduced appetite are symptoms of an ancient disease that poses a lurking threat

Hannah is a 38-year-old hotel reception worker who attends with worsening back pain.

back pain

When asked to localise the pain, she points to her lower thoracic spine. The pain is worse with standing and radiates to her groin.

She has noticed variable parasthesiae in her thighs and calves, but this seems to be quite random and unrelated to any specific activity.

In the past month, she has lost her appetite and with it more than 5kg. She denies any other symptoms, including night sweats, rigors and malaise.