{"ops":[{"insert":"A 30 year old veterinarian presents with nocturnal pain in the right lower back for 2 weeks, in association with fatigability, night sweats, and fever with chills at night.\n\nHe migrated from Brazil to the United States 3 weeks ago. He had been working in the same occupation in his home country.\n\nHis medical history is unremarkable. There is no history of contact with tuberculosis. He has a single stable sexual partner. There is no family history of spondyloarthropathies.\n\nHis ESR is found to be 20 mm\/1h. Radiographs of the pelvis are found to be normal. A tuberculin test was performed in view of the symptoms, but is nonreactive.\n\nPrior to migration, he was tested for HIV and found to be negative.\n"},{"insert":"\n"},{"insert":{"image":"\/storage\/case-images\/pd\/PD-M-147_en.png"}},{"insert":"\n"}]}
2
Investigate
MRI Lumbar Spine + B/L SI Joints
{"ops":[{"insert":"There is a widening of the R\/s sacroiliac joint, with enhancement of the fluid within. A high diffuse signal intensity is seen in the bone marrow. \nThe L\/s sacroiliac joint appears normal. There is no evidence of erosions or sclerosis. \nThe lumbar spine appears normal.\n"}]}