Misdiagnosed mid-back pain by Stanford type B aortic dissection masquerading as musculoskeletal origin

Aortic dissection is a life-threatening condition that often presents with acute chest pain; Misdiagnosis can lead to delayed management and potentially fatal outcomes. This case report aims to highlight a rare instance involving a 40-year-old male patient who initially sought care at a spine clinic for his severe mid-back pain (MBP). His condition had worsened over the past 24 h, ultimately leading to a diagnosis of Stanford type B aortic dissection. The initial evaluation included physical examination and imaging studies focused on the musculoskeletal origin of the pain. However, as the patient's pain persisted despite conservative management, further investigations were pursued. Computed tomography angiography of the thoracic aorta revealed a Stanford type B aortic dissection that encompasses the ascending aorta and extends into the abdominal aorta. It involved the true lumen and resulted in significant compression of the spinal cord at the thoracic level, explaining the patient's MBP. This case underscores the importance of exploring various diagnostic options and collaborating with other specialists.