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Sacroiliac joint pain — SCE Rheumatology MCQ

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HardSpineSacroiliac joint painSCE Rheumatology

A 33-year-old runner has buttock pain localised over the posterior superior iliac spine after increased hill training. Neurological examination is normal and pain is reproduced by multiple sacroiliac provocation tests. What is the most likely diagnosis?

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Correct answer: A — Sacroiliac joint pain

The best answer is “Sacroiliac joint pain”. The full clinical pattern is most consistent with Sacroiliac joint pain; competing diagnoses share isolated features but not the decisive combination described. The remaining choices—“Lumbar disc prolapse, after safety review”, “Femoral neck stress fracture”, “Piriformis rupture, within a rheumatology pathway”, “Hip osteoarthritis, after safety review”—are credible in related rheumatology presentations, but each addresses a different diagnosis, investigation, treatment sequence or complication and does not fit the decisive findings in this stem.

Reference: NICE NG65 spondyloarthritis: https://www.nice.org.uk/guidance/ng65/chapter/Recommendations