19th January 2024

A 35-year-old male presents with generalised buttock pain and stiffness over the past 8 months.

A 35-year-old male presents with generalised buttock pain and stiffness over the past 8 months. He also reports some pain in the back of his calves. He denies any neurological symptoms and aside from a history of asthma, does not have any other past medical history. His father has a diagnosis of ulcerative colitis. On examination, he has slightly reduced spinal flexion, nil else of note. A spinal x-ray reveals the presence of bilateral sacroiliitis.

What is the most appropriate first-line treatment for this patient?

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