Inflammatory Bowel Disease USMLE Step 1 Practice Question
A 52-year-old man with 15 years of Crohn disease affecting multiple bowel segments presents with acute onset of severe back pain and progressive morning stiffness lasting 2 hours. Vital signs: BP 128/82, HR 92, RR 16, Temp 37.2°C. Laboratory studies show elevated ESR at 48 mm/hr. Spinal imaging reveals a fused and inflexible spine with anterior syndesmophytes. He denies peripheral joint swelling. Which of the following is the most likely diagnosis?
Answer choices
- AAxial spondyloarthritis associated with Crohn diseaseCorrect answer
- BAnkylosing spondylitis independent of IBD
- COsteoporosis with compression fractures
- DSpinal tuberculosis from disseminated infection
- ELumbar stenosis from chronic inflammation
- FDiffuse idiopathic skeletal hyperostosis (DISH) with secondary inflammatory changes
See the full explanation
Get the correct-answer rationale, why each distractor is wrong, the underlying mechanism, and high-yield associations — plus adaptive practice that targets your weak areas — with a free MedBoardPRO account.