23-year-old woman comes to the office due to progressive low back pain and stiffness. The pain has been present for the last few
years and has worsened somewhat in recent weeks. The patient has relief of the pain with physical activity and over-the-counter
ibuprofen. Associated symptoms include morning stiffness that usually lasts an hour, but she has had no rash, ocular symptoms,
urinary symptoms, or diarrhea. Medical history is notable only for an appendectomy at age 11. The patient has taken birth control
pills for the past 2 years and is sexually active with one partner. On examination, she is afebrile with normal height and weight There
is reduced forward flexion of the lumbar spine and tenderness over the lumbosacral area. The remainder of the physical examination
is normal. Which of the following would be most likely to establish a diagnosis in this patient?
- QA Antinuclear antibodies
- 0 B. Erythrocyte sedimentation rate
- 0 C. HLA-B27 testing
- 0 D. Nuclear medicine bone scan
- 0 E. Prednisone therapeutic trial
- 0 F. Rheumatoid factor
- 0 G. X-ray of the sacroiliac joints
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