Eye conditions Quiz: Ace Your Exams

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A 28-year-old man comes to his primary care physician for evaluation of persistent low back pain and stiffness of several weeks duration. The pain is worse in the morning and gradually improves with activity throughout the day. The patient is sexually active and has had four partners in the past year. Vital signs are within normal limits. Physical examination demonstrates limited spine flexion and tenderness to palpation of the lumbar spine. Laboratory results show a microcytic anemia and an elevated platelet count. An x-ray of the lumbar spine is demonstrated below. Further history is most likely to reveal which of the following clinical features?

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Acute unilateral eye pain and blurring of vision

Genital ulcerations

Unilateral or bilateral external ear inflammation

Chronic dry cough, dyspnea, and chest pain

Erythema in a malar distribution over the cheeks and nose