A 27-year-old man has a history of low back pain and stiffness. After several months of mild symptoms, he notes more severe stiffness at night and hip pain. On physical examination, there is paravertebral muscle tenderness and limited flexion of the lumbar spine. X-ray of the lumbar spine shows sacroiliitis. In addition to recommending physiotherapy and exercise, which of the following is the most appropriate next step in management?
All NSAIDs are probably equally effective in the treatment of this man's ankylosing spondylitis. Options include indomethacin or naproxen, but not phenylbutazone since it can cause aplastic anemia. Exercise and maintaining proper posture are very important.
NSAID therapy
phenylbutazone
azathioprine
acetaminophen
Miscellaneous