A 34-year-old man comes to the physician because of increasing lower back and neck pain for the past 7 months. The pain is worse in the morning and improves when he plays basketball. He has noticed shortness of breath while playing for the past 2 months. He is sexually active with two female partners and uses condoms inconsistently. He appears lethargic. His vital signs are within normal limits. Examination of the back shows tenderness over the sacroiliac joints. Range of motion is limited by pain. The lungs are clear to auscultation. Which of the following is most helpful to monitor disease progression in this patient?

Question

A 34-year-old man comes to the physician because of increasing lower back and neck pain for the past 7 months. The pain is worse in the morning and improves when he plays basketball. He has noticed shortness of breath while playing for the past 2 months. He is sexually active with two female partners and uses condoms inconsistently. He appears lethargic. His vital signs are within normal limits. Examination of the back shows tenderness over the sacroiliac joints. Range of motion is limited by pain. The lungs are clear to auscultation.   Which of the following is most helpful to monitor disease progression in this patient?

Quizplus · Accepted Answer

Eductional Objective: Ankylosing spondylitis is characterized by stiffness and fusion of axial joints (ankylosis) and inflammation at the site of insertion of tendons into bone (enthesitis).  Involvement of the thoracic spine and costovertebral and costosternal junctions can limit chest wall expansion, leading to hypoventilation.

A 34-Year-Old Man Comes to the Physician Because of Increasing