Which presentation best aligns with seronegative spondyloarthropathy?

• A. Acute chest pain relieved by rest
• B. Blurred vision with photophobia
• C. History of iritis, morning stiffness that improves with exercise, and a family history
• D. Abdominal pain after meals

Answer: (C)

Inflammatory back pain with extra-articular features is the hallmark of seronegative spondyloarthropathies. The presentation described—iritis (anterior uveitis) along with morning stiffness that improves with exercise and a family history—fits this pattern best. Inflammatory back pain typically shows pain and stiffness that are worse after rest and improve with activity, and axial involvement is a key feature of these conditions. Iritis is a common extra-articular manifestation, and a family history supports the genetic predisposition often seen with HLA-B27–associated spondyloarthropathies.

The other options don’t align as well with this disease group: acute chest pain relieved by rest points more to cardiac issues; blurred vision with photophobia could reflect ocular inflammation but lacks the accompanying inflammatory back pain and family history; abdominal pain after meals suggests a gastrointestinal issue rather than a seronegative spondyloarthropathy.