Neville is a 71-year-old retiree who presents with progressive headache and neck pain over the past few weeks. 

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<p>Neville is a 71-year-old retiree who presents with progressive headache and neck pain over the past few weeks.</p><p>There is no history of trauma or injury. There is no other joint pain or associated visual, neurological, cardiorespiratory or abdominal symptoms.</p><p>He reports no recent fever or infective illness. On examination, his temperature is 37.9°C, with otherwise normal vital signs.</p><p>His cervical spine range of motion is limited in all planes. There are no signs of meningism, rash or lymphadenopathy.</p><p>Pathology reveals CRP is 85mg/L (normal: &lt;5mg/L), with normal FBC and autoimmune inflammatory markers.</p><p>CT brain is unremarkable. Cervical spine CT findings (coronal plane) are pictured.</p>

Dr Kate Kelso is a GP and medical editor at Australian Doctor.