Patho ? - belkin

[ArchivalUser]

A 48-year-old man has a 25-year history of lower back pain that began in the sacroiliac joints. He has been taking nonsteroidal anti-inflammatory drugs intermittently. He exhibits no sign of fever. Physical examination shows a stooped posture and tenderness in all the vertebral joints. A high-pitched early diastolic murmur is heard in the second intercostal space on the right. A radiograph of the spine shows forward curvature of the spine with fusion of the lumbar vertebrae. Laboratory test detected the HLA-B27 genotype. The disease process in this patient started in which area?



A. Articular cartilage
B. Ligamentous attachments to bones
C. Soft tissue around joints
D. Subchondral bone around the joints
E. Synovial membrane

[ArchivalUser]

B?

[ArchivalUser]

i guess AA ank spond Articular cartilage

[ArchivalUser]

B.[ENTHESOPATHY]

[ArchivalUser]

E?

[ArchivalUser]

Option B (Ligamentous attachments to bones) is correct. The kyphosis with fusion of the lumbar vertebrae, plus a history of lower lumbar pain beginning in the sacroiliac joints, suggests ankylosing spondylitis. The disease process begins in the ligamentous attachment to bones. This disorder is a part of a related group of disorders called seronegative spondyloarthropathies.