# Myelofibrosis as an Unusual Cause of Back Pain: A Case Report

## TL;DR

A 76-year-old man's persistent back and side pain led to a rare diagnosis of myelofibrosis, highlighting the importance of considering uncommon causes in unresponsive pain cases.

## Contribution

This case report adds myelofibrosis to the differential diagnosis of refractory back and flank pain.

## Key findings

- A 76-year-old male presented with unresponsive back and side pain.
- Diagnostic workup revealed myelofibrosis as the underlying cause.
- The case underscores the need for broad differential diagnosis in persistent pain.

## Abstract

Low back pain and, to a lesser degree, associated flank pain are common presentations to an integrative musculoskeletal clinic. Most cases have a neuromusculoskeletal or, less commonly, a urological etiology. Myelofibrosis is a chronic, uncommon blood neoplasm. Here, we describe the clinical presentation and diagnostic workup of a 76-year-old male who complained of back and side pain that did not respond to an initial trial of care. The case is followed through the diagnostic process, leading to the final diagnosis of myelofibrosis. This case emphasizes the need for further workup and a broad-spectrum differential diagnosis in cases of back and flank pain that do not respond to care, including consideration of myelofibrosis as a rare etiology.