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Old 07-01-2011
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Question Lower back pain

A 20 year old man complains of lower back pain and stiffness that is worse on arising and improves with exercise. On examination, he is found to have limited mobility of the sacroiliac joint and lumbar spine . A serum test for histocompatibility antigen HLA-B27 is positive. What is the most common extraskeletal manifestation of this disease?

A. Premature cataracts
B. Splenomaegly
C. Acute iritis
D. Aortic insufficiency
E. Pulmonary fibrosis
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Old 07-01-2011
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C. Acute iritis

Unilateral uveitis is the most common extraarticular complication of AS, occurring in 25 to 40 percent of patients. The occurrence of uveitis may be the first problem to require medical evaluation and should alert physicians to the possibility of AS. About 50 percent of patients with acute recurrent unilateral anterior uveitis have spondyloarthritis. There is no correlation between the activity and severity of the eye disease and those of the articular disease.
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Old 07-02-2011
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Answer C. Acute Iritis > the most common extraskeletal manifestations of ankylosing sponylitis is acute iridocyclitis, occuring in 25-30% of ptients; other manifestations are heart block, aortitis, pulmonary fibrosis.
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