History A seventy-one year old gentleman complained of weakness in his thighs, stiffness in his hip girdle and discomfort from his hips to his knees. He was unable to stand up from a chair without pushing himself up with his arms and throwing his weight forward. The patient also complained of general stiffness after resting for a short period. Hip and thigh pain on short-distance walks was profound. He found improvement in the hip girdle pain when lying flat or sitting.
He had problems with decreased mobility of his back for years and was told he had “spondylosis” of his spine. Physical Examination His general examination was unremarkable. The musculoskeletal exam demonstrated mild limitation of motion of the cervical spine, and normal range of motion of the thoracic spine. His lumbar spine was remarkable for loss of the normal lordotic curve (flattening), and decreased range of motion…
