Severe back pain in a hemodialysis patient

A 68-year-old woman was admitted because of severe lower back pain for 2 months. She had diabetes nephropathy in uremic state and began regular hemodialysis for 2 years. Her blood pressure was 130/70 mmHg, body temperature 37°C, pulse rate 70 beats/min and respiratory rate 18 breaths/min. On examination, tenderness of L-spine without any neurological deficient was noted. Laboratory data showed white blood cell counts 13 100/μl with a left shift, and C-reactive protein …