Spontaneous pneumomediastinum (SPM) is an uncommon condition characterized by air in the interstices of the mediastinum. Management generally involves supportive care; however, if a patient inspires high concentrations of oxygen, the mediastinal air will be absorbed faster. A 23-year-old man who presented with acute-onset breathlessness with a history of more than a year of lower backache was diagnosed with SPM and accompanying ankylosing spondylitis (AS) by a chest CT and spinal MRI and was treated conservatively.
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