Activity in Medicine / Internal Medicine — 28yo Man | Rheumatology | SMLE Q#18575
SMLE Question #18575
Medicine / Internal Medicine
Rheumatology
Objective: OBJ-IM-RHEUM-AXSPA-1
Last updated: February 2026
A 28-year-old man has 6 months of low back pain that is worse in the morning and improves with activity. Morning stiffness lasts about 60 minutes. He has intermittent pain and swelling in both knees and ankles. He denies psoriasis, eye redness, urethral discharge, oral ulcers, and diarrhea. Examination shows reduced lumbar flexion with a positive modified Schober test, bilateral knee synovitis, and tenderness at the Achilles tendon insertion. Pelvic radiographs show no sacroiliitis. Which investigation is most appropriate to establish the diagnosis?
Continue in practice mode
Sign in and start a focused practice session to view options, submit your answer, and read the full explanation.