A case of axial undifferentiated spondyloarthritis diagnosis and management.
BACKGROUND
A 32-year-old white man presented with features of inflammatory back pain, including awakening at night and morning stiffness. He had acute back pain 4 years earlier as a result of a herniated lumbar disc.


METHODS
The orthopedic consultation included tests for neurologic deficits; a Lasègue test; a finger-to-floor distance test; X-rays of the lumbar spine; and MRI of the lumbar spine. The rheumatologic consultation included recordal of clinical history and family history; physical examination, including a Schober's test, lateral spine flexion, chest expansion, cervical rotation, and tragus-to-wall distance; blood tests, including genotyping for human leukocyte antigen B27 positivity, and measurements of C-reactive protein level and erythrocyte sedimentation rate; MRI of the sacroiliac joints with use of short tau inversion recovery sequences; and measurement of the Bath Ankylosing Spondylitis Disease Activity Index and the Bath Ankylosing Spondylitis Functional Index.


METHODS
Axial undifferentiated spondyloarthritis.


RESULTS
NSAIDs and physiotherapy.
Rudwaleit
Martin
M
Rheumatology, Department of Medicine I, Charitè Universitätsmedizin, Berlin, Germany. martin.rudwaleit@charite.de
Sieper
Joachim
J
D000328:Adult; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D004185:Disability Evaluation; D005081:Exercise Therapy; D006801:Humans; D017116:Low Back Pain / Q000175:diagnosis / Q000503:physiopathology / Q000534:rehabilitation; D008279:Magnetic Resonance Imaging; D008297:Male; D011859:Radiography; D020127:Recovery of Function; D012720:Severity of Illness Index; D013131:Spine / Q000473:pathology* / Q000503:physiopathology; D013167:Spondylitis, Ankylosing / Q000175:diagnosis* / Q000503:physiopathology / Q000534:rehabilitation*; D016896:Treatment Outcome
D000893:Anti-Inflammatory Agents; D000894:Anti-Inflammatory Agents, Non-Steroidal