A 34-Year-Old Man Comes to the Office Due to Progressive

A 34-year-old man comes to the office due to progressive low back pain for several years.  The patient reports that the stiffness and pain are worst in the morning but gradually improve during the day.  Lately, he has been taking over-the-counter ibuprofen, which provides some relief.  Laboratory evaluation shows a positive HLA-B27 antigen.  X-ray imaging reveals fusion of the sacroiliac joints.  Which of the following is most helpful to monitor disease progression in this patient?

A) Degree of chest expansion
B) Hand joint mobility
C) Peak expiratory flow rate
D) Rheumatoid factor level
E) Urine protein level

Correct Answer:

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