QuestionSBA
QuestionChoice
The diagnosis, in this case, is ankylosing spondylitis as this young man has presented with back pain, restricted spinal movement and a positive Schober's test. This condition is also associated with a "bamboo-spine" appearance on X-ray. The first-line management for ankylosing spondylitis is NSAIDs. Long-term NSAID use may cause gastric problems such as peptic ulcers, hence PPIs should be co-prescribed.
10003681
a
NSAID + PPI
QuestionChoice
The diagnosis, in this case, is ankylosing spondylitis as this young man has presented with back pain, restricted spinal movement and a positive Schober test. This condition is also associated with a "bamboo-spine" appearance on X-ray. Paracetamol has no role in the management of ankylosing spondylitis.
10003684
d
Paracetamol
QuestionChoice
The diagnosis, in this case, is ankylosing spondylitis as this young man has presented with back pain, restricted spinal movement and a positive Schober test. This condition is also associated with a "bamboo-spine" appearance on X-ray. Infliximab is a TNF-alpha inhibitor and is normally given if symptoms have not been controlled effectively by NSAIDs or if a patient has severe disease.
10003685
e
Infliximab
QuestionChoice
The diagnosis, in this case, is ankylosing spondylitis as this young man has presented with back pain, restricted spinal movement and a positive Schober test. This condition is also associated with a "bamboo-spine" appearance on X-ray. Local steroid injections can help ease the pain in ankylosing spondylitis, but cannot be injected into the spine making it unsuitable for this patient.
10003683
c
Steroid injections
QuestionChoice
The diagnosis, in this case, is ankylosing spondylitis as this young man has presented with back pain, restricted spinal movement and a positive Schober test. This condition is also associated with a "bamboo-spine" appearance on X-ray. Methotrexate is a disease-modifying antirheumatic drug (DMARD) and tends to be more useful in patients with enthesitis as opposed to axial symptoms. It would also not improve spinal inflammation.
10003682
b
Methotrexate
Concept
Chapter
2693
3911
ankylosing spondylitis
Topic
146
Rheumatology
13283
A 24-year-old man presents to the Rheumatology Clinic reporting back pain and stiffness that gets better throughout the day. On examination, he has reduced range of movement of his lumbar spine and a positive Schober test.

What is the first-line management of this condition?
a