A 52-year-old man with 15 years of Crohn disease affecting multiple bowel segments presents with acute onset of severe back pain and progressive morning stiffness lasting 2 hours. Vital signs: BP 128/82, HR 92, RR 16, Temp 37.2°C. Laboratory studies show elevated ESR at 48 mm/hr. Spinal imaging reveals a fused and inflexible spine with anterior syndesmophytes. He denies peripheral joint swelling. Which of the following is the most likely diagnosis?

  1. A)Axial spondyloarthritis associated with Crohn diseaseGABARITO
  2. B)Ankylosing spondylitis independent of IBD
  3. C)Osteoporosis with compression fractures
  4. D)Spinal tuberculosis from disseminated infection
  5. E)Lumbar stenosis from chronic inflammation

Explicação

Axial spondyloarthritis, including ankylosing spondylitis and non-radiographic axial SpA, is an extraintestinal manifestation of IBD, particularly Crohn disease. It presents with inflammatory back pain, morning stiffness, and radiographic findings of syndesmop... Ver explicação completa e trilha adaptativa →

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