Best of Five 2.133

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BOF: 2.133

A 37-year-old male presents with a history of pain and swelling of his knees. He also has a low backache.. He also complains of pain and redness of his eyes and he has a discharge per urethra. 2 weeks prior to the onset of the illness he had diarrhoea for several days. This was self-limiting.

He is not on any medications, smoke 5 cigarettes a day and takes 12 units of alcohol per week. He is married has 2 children and is an accountant.

On examination of his knees there are bilateral effusions and limitation of movement. Aspiration of the joint shows that the effusion is sterile. X-ray of his pelvis shows sacroiliitis.

What is the likely diagnosis?

a)      Gonococcal arthritis

b)      Enteropathic arthropathy

c)      Rheumatoid arthritis

d)      Ankylosing spondylitis

e)      Reactive arthritis

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