A 30-year-old man presents with lower back pain and stiffness that is worse in the morning and improves with activity. The pain has been ongoing for several months. He also reports occasional red, painful eyes. What are the potential diagnoses and next steps?
This patient's chronic lower back pain, especially with morning stiffness that improves with activity, coupled with episodes of red, painful eyes (which could represent uveitis), suggests the possibility of ankylosing spondylitis (AS). This is a form of inflammatory arthritis that primarily affects the spine. HLA-B27 testing can help support the diagnosis, and imaging, including X-rays or MRI of the spine and sacroiliac joints, can show characteristic changes.