A patient with back pain: what is hidden under the diagnosis «osteochondrosis»
Kadyrova L.R.¹, Bashkova I.B.^2,4, Kiseleva I.N.³, Bezlyudnaya N.V.⁴, Habarova O.A.^2,3, Burtsev A.K.<sup>5

1</sup> Kazan State Medical Academy
² Chuvash State University named after I.N. Ulyanov, Cheboksary
³ Republican Endocrinology dispensary, Cheboksary
⁴ Federal center of traumatology, orthopedics and joint replacement, Cheboksary
⁵ Republican Clinical Oncology Center, Cheboksary

The paper discusses the problem of back pain. Basically diagnostic search for pain causes should be aimed to identify symptoms of specific diseases. The paper addresses diagnosis and treatment of nonspecific back pain, which includes non-steroidal anti-inflammatory drugs (NSAIDs). Special attention is paid to nimesulide, which is effective NSAID in patients with pain and inflammatory component. Data on nimesulide safety in comparison with other NSAIDs, most commonly used in clinical practice, is observed. The second part of the article focuses on causes of specific back pain. Main "dangerous” symptoms, requiring special attention during anamnesis collection and physical examination, are discussed. Authors presented two clinical cases from own practice, when patients with back pain attended primary care physicians for a long time with a diagnosis "osteochondrosis". The first clinical case study describes 66-years old female with multiple myeloma. The second clinical case study describes 53-years old male with primary hyperparathyroidism, symptomatic bone-visceral form. The objective of the article is to remind clinicians that big variety of diseases can cause back pain. 

Key words: back pain, osteochondrosis, osteoporosis, hypercalcaemia, hyperparathyroidism, multiple myeloma, differential diagnosis

For citation: Kadyrova L.R., Bashkova I.B., Kiseleva I.N. et al. A patient with back pain: what is hidden under the diagnosis «osteochondrosis» // RMJ. 2016. № 14. P. 886–893.