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A young Ghanese girl with backpain

A girl of Ghanese origin presented with acute back pain. The X-ray of the spine showed characteristic biconcave vertebral bodies, known as ‘H-deformities’ or ‘fish-vertebrae’, caused by micro-infarctions in the central portion of the vertebral end plate. After hemoglobinopathy tests, the patient was diagnosed with a pain crisis caused by sickle-cell disease (HbSC) and admitted for analgesia.