A 26-year-old male had a 2 years history of severe back pain. He was out of the country, so was on and off anti-inflammatory drugs. He came with severe stiffness and inability to move neck and back. Had tenderness over spinous process. Neurologically intact. No other joint involvement. Esr 67 and Crp positive. Rest all arthritic profile was normal including negative Hlab27.
His MRI has been attached. I have started him on Prednisolone 10mg bd for one month along with DMARDs, Leflunomide and sulfasalazine. Also given anti-inflammatory meds. His pain and stiffness reduced. Given Taylor's brace but not using. MRI shows not so bad sagittal picture so I am planning conservative management only. Please guide me about any biologics or other injections available in the market. Will they help?
