Back pain and dyspnoea in a middle aged diabetic male

Answers on p245. A 59 year old insulin dependent diabetic male presented with an eight week history of lower thoracic back pain and a two to three week history of progressive exertional dyspnoea, limiting his exercise tolerance to around 100 yards, associated with mild ankle oedema. He did not complain of cough or chest pain. He had been discharged from another hospital four weeks earlier after a prolonged admission with pneumonia and renal failure. There was no other past medical history of note. In particular, there …