ادامه Lower Back Pain and Stiffness in a Diabetic Man

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On physical examination, the patient is afebrile, with a pulse of 68 bpm, a blood pressure of 138/82 mm Hg, and a normal respiratory rate. His weight is 159 lb (72 kg); height is 5 ft 3 in (63 in, 160 cm); and body mass index is 28.1 kg/m2. His waist circumference is 40 in (102 cm). His cardiopulmonary and neurologic examinations are normal. His abdomen is soft and without organomegaly. He is noted to have a forward stooping posture with loss of lumbar curvature of the spine. Detailed examination of the spine confirms an exaggerated dorsal spine curvature and loss of normal lumbar lordosis. There is slight local tenderness over the lumbar spine. There is restriction of forward and lateral flexion of the spine as assessed by Schober's test and finger-floor test on sideway bending. There is also restricted neck movement. There is no discernible spinal or paraspinal swelling, and the peripheral and sacroiliac joints are not tender.
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