A 21 y.o. man complains of having morning pains in his back for the last three months. The pain can be relieved during the day and after physical exercises. Physical examination revealed reduced mobility in the lumbar part of his spine, increase of muscle tonus in the lumbar area and sluch during moving. X-ray pattern of spine revealed bilateral sclerotic changes in the sacrolumbal part. What test will be the most necessary for confirming a diagnosis?

Answer options

1. ESR
2. Uric acid in blood plasma
3. Antinuclear antibodies
4. Rheumatoid factor
5. HLA-B27

Explanation

A 21 y.o. man complains of having morning pains in his back for the last three months. The pain can be relieved during the day and after physical exercises. Physical examination revealed reduced mobility in the lumbar part of his spine, increase of muscle tonus in the lumbar area and sluch during moving. X-ray pattern of spine revealed bilateral sclerotic changes in the sacrolumbal part. What test will be the most necessary for confirming a diagnosis?Ankylosing spondylitis is an inflammatory disease that, over time, can cause some of the vertebrae of the spine to fuse. This fusing makes the spine less flexible and can result in a hunched-forward posture. It affects men (over 38 yr) more than women. Early signs and symptoms of ankylosing spondylitis might include pain and stiffness in the lower back and hips, especially in the morning and after periods of inactivity. Neck pain and fatigue also are common. It is associated with HLA- B27 gene. (MRI), and X-ray studies of the spine, which show characteristic spinal changes and inflammation of the sacroiliac joint, combined with a genetic marker blood test are the major diagnostic tools. Schober's test is a useful clinical measure of flexion of the lumbar spine performed during the physical examination. X-ray showing the bamboo spine in a person with ankylosing spondylitis because of longitudinal ligament ossification.