Morning Stiffness That Improves in Medicine / Internal Medicine — 28yo Man | Rheumatology | SMLE Q#12438

SMLE Question #12438

Medicine / Internal Medicine Rheumatology

Objective: OBJ-383

Last updated: February 2026
A 28-year-old man has 4 months of dull low back pain with morning stiffness that improves with activity. He also reports intermittent bilateral knee pain and swelling. Examination shows reduced lumbar flexion, pain with sacroiliac joint compression, and mild bilateral knee effusions without erythema. Plain radiographs of the lumbar spine and sacroiliac joints are unremarkable. The clinician suspects early axial spondyloarthritis. What is the most appropriate next diagnostic approach?

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