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. Chest expansion is decreased on full inspiration. Erythrocyte sedimentation rate is 75 mm/hr. Which of the following pathologic findings is most likely causing this patient's symptoms?

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. Chest expansion is decreased on full inspiration. Erythrocyte sedimentation rate is 75 mm/hr.  Which of the following pathologic findings is most likely causing this patient's symptoms?

Quizplus · Accepted Answer

Eductional Objective: Ankylosing spondylitis is an inflammatory spondyloarthropathy characterized by simultaneous erosion of bone and new bone formation.  Bone erosions occur primarily in vertebral bodies; however, new bone formation typically occurs at the junction of the periosteal margin and adjacent cartilage, leading to bridging syndesmophytes and ankylosis.  This causes spinal rigidity, postural alterations, and increased risk of fracture.

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