A 26-year-old man presented with a 6-month history of back and buttock pain and stiffness. He also mentioned that the symptoms are localized to lumbar and right buttock particularly after waking up in the morning, but the pain recedes after some hours. The pain does not spread down the back of the leg and no issues with sensation or strength in the leg. This man is otherwise fit but smokes heavily. Examination Dramatically restricted lumbar spine movements in all planes.
Cervical movements were full and pain-free Right hip is irritable with reduced range of movement, particularly external rotation Small effusion of the left knee with evidence of Achilles tendinopathy and plantar fasciitis on the left foot. MRI of the lumbosacral spine and sacroiliac joints was performed (Images attached). What is the most likely diagnosis? What observations can be made from MRI images? *This case is…
