skip to main content

Ankylosing Spondylitis — RACP Adult Medicine MCQ

Instant feedback + full explanation. One question, done properly.

EasyRheumatologyAnkylosing SpondylitisRACP Adult Medicine

A 25-year-old man presents with inflammatory back pain (worse at rest, improves with exercise, morning stiffness >30 minutes) for 6 months. He has bilateral sacroiliitis on MRI (bone marrow oedema). HLA-B27 is positive. He also has anterior uveitis. What is the most likely diagnosis?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: B — Ankylosing spondylitis

Inflammatory back pain with bilateral sacroiliitis on MRI, HLA-B27 positivity, and anterior uveitis in a young man is classic axial spondyloarthritis (ankylosing spondylitis). ASAS criteria are used for classification. First-line treatment is NSAIDs. If refractory, biologic DMARDs (anti-TNF or IL-17 inhibitors) are indicated. There is no role for methotrexate in axial disease.

Reference: ASAS/EULAR – 2023 – Axial SpA Management; ARA 2024