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Axial spondyloarthritis — RCPSC IM MCQ

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HardRheumatologyAxial spondyloarthritisRCPSC IM

A 27-year-old man has 18 months of inflammatory back pain, morning stiffness improving with exercise and alternating buttock pain. CRP is mildly elevated and HLA-B27 is positive. Plain pelvic radiograph is normal. He has anterior uveitis history. What is the most appropriate investigation?

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Correct answer: B — MRI of the sacroiliac joints

Inflammatory back pain with HLA-B27 positivity and uveitis suggests axial spondyloarthritis. MRI can detect active sacroiliitis before radiographic changes appear.

Reference: Canadian Rheumatology Association axial spondyloarthritis living guideline