Background and purpose: Spondyloarthropathy (SpA) is a rare inflammatory arthritic condition misdiagnosed due to its presentation of similar diagnoses. The purpose of this case report is to demonstrate the physical therapist’s capability to differentially diagnose SpA with a thorough examination and evaluation of the clinical findings. Case Description: The patient is a 48-year-old Caucasian male who presents with pain and a progressive loss of mobility bilaterally in the neck and shoulders over the past two years in addition to a ten-year history of chronic low back and neck pain. The outcome measure utilized was the neck disability index (NDI). The physical therapist evaluated the patient for physical therapy, differentially diagnosed …show more content…
His Neck Disability Index (NDI) improved from 13/50 to 10/50. His pain decreased to a 0/10 at rest and 3/10 at worst.

Discussion: Medical treatment and physical therapy intervention have revealed to be beneficial for patients diagnosed with SpA. By examining a patient thoroughly and clinically reasoning through atypical findings allow physical therapists to use those factors to differentially diagnose conditions and refer them out to the appropriate healthcare professional.

Introduction
Neck pain is a common condition that is prevalent in many people, which limits their functional ability.1 In 2010, the global prevalence of neck pain was roughly 4.9% of the population and ranked fourth highest for being a disability for an individual.2 Neck pain has a wide span of differential diagnosis that ranges from a simple mechanical issue to a more permanent condition such as an arthritic condition. The United States spends $128 billion on managing arthritic condition per year.3 Cervical spondyloarthropathy, synonymous with spondyloarthritis (SpA), is a severe arthritic condition that can affect the neck. SpA is inflammatory arthritis comprised of various interrelated disorders diagnosed by a cluster of clinical findings and mainly treated medically through the use of injections and …show more content…
The Numeric Pain Rating Scale (NPRS) is a 0 to 10 scale that a patient can subjectively rate their pain from 0, no pain at all to 10, which is worst pain experienced.13 Rogelio et al.13 used NPRS to gauge changes in a patient with SpA from their initial physical therapy visit through their follow up. The patient received physical therapy, oral prednisone, and Humira.13 The patient’s NPRS began physical therapy with a rating of 6/10 and on the follow up, the patient report 0/10 pain.13 The NPRS illustrated a good improvement in the patient’s perceived pain. The current case report also uses the NPRS and evidence to support improvement in the patient while also exceeding MCID for that outcome measure. The patient in the case report displayed improvement from a 0/10 - 2/10 at rest to a 0/10 and from a 10/10 at worst to a 3/10. This score surpasses MCID of 4.1 with a 7 point