Positive Modified Schober Test in Medicine / Internal Medicine — 28yo Man | Rheumatology | SMLE Q#18265

SMLE Question #18265

Medicine / Internal Medicine Rheumatology

Objective: OBJ-IM-RHEUM-AXSPA-1

Last updated: February 2026
A 28-year-old man has 6 months of inflammatory low back pain and morning stiffness lasting about 60 minutes. He also has intermittent swelling and pain in both knees and ankles. He denies psoriasis, oral/genital ulcers, and preceding diarrheal or urethral symptoms. Examination shows reduced lumbar flexion with a positive modified Schober test, bilateral knee synovitis, and tenderness at the Achilles tendon insertion. Which of the following investigations is most appropriate to establish the diagnosis?

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