25th February 2025

A 40-year-old man is seen complaining of years of worsening lower back pain, which can wake him up at night.

A 40-year-old man is seen complaining of years of worsening lower back pain, which can wake him up at night. He is managing it with anti-inflammatories, and it tends to improve throughout the day. He also describes fatigue, mild weight loss, a dry cough and shortness of breath when exercising. An X-ray of the lumbar spine is taken.

What is the likely diagnosis?

Select the SINGLE most appropriate option from the list below. Select ONE option only.