Seronegative and septic arthritis Quiz: Ace Your Exams

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A 40-year-old man comes to his primary care physician’s office for evaluation of worsening low back pain and stiffness for 2 years. The pain is worse in the morning or after a prolonged period of rest. Review of systems is positive for exertional dyspnea. Recently, he began taking over-the-counter acetaminophen, providing some relief. Vitals are within normal limits. Physical examination demonstrates restricted forward flexion of lumbar spine. When the patient is asked to raise his arms above his head and exert a maximal forced expiration followed by a maximal inspiration, the chest expansion observed is1.4 cm (normal 6.5 cm). Chest x-ray is normal. His spinal radiograph is shown below.  

A lateral X-ray of a spine shows lumbar vertebrae, intervertebral discs, and the pelvis. The bone structure is visible against a dark background.
Reproduced from: Radiopedia.org  

Which of the following findings is most likely to be observed in this patient on spirometry?  

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