A 20-year-old boy consults for lumbosacral pain of inflammatory rhythm of 4 months of evolution. Also bilateral thalalgia and morning stiffness for 1 hour. In the last 2 months, onset of diarrhea with loss of 4 kg of weight. What is the most correct diagnostic approach?
The clinical picture is typical of spondyloarthritis, and together with the digestive symptoms it is probably associated with inflammatory bowel disease.
Given the patient's age, he most likely suffers from non-specific low back pain and tendonitis in the feet. If the diarrhea persists, a digestive study would be performed.
I would perform a digestive study to rule out tumor pathology. The lumbar pain may be due to visceral pathology.
The clinical picture is very suggestive of spondyloarthritis. Inflammatory bowel disease should be ruled out.
I would request a lumbar MRI to rule out disc herniation and if diarrhea persists, a digestive study.
The clinical picture is typical of spondyloarthritis, and together with the digestive symptoms it is probably associated with inflammatory bowel disease.