question: Q:A 34-year-old man comes to the physician because of increasing lower back and neck pain for the past 7 months. The pain is worse in the morning and improves when he plays basketball. He has noticed shortness of breath while playing for the past 2 months. He is sexually active with 2 female partners and uses condoms inconsistently. He appears lethargic. His vital signs are within normal limits. Examination of the back shows tenderness over the sacroiliac joints. Range of motion is limited. The lungs are clear to auscultation. Chest expansion is decreased on full inspiration. His leukocyte count is 14,000/mm3 and erythrocyte sedimentation rate is 84 mm/h. An x-ray of the spine shows erosion and sclerosis of the sacroiliac joints and loss of spinal lordosis. Further evaluation of this patient is most likely to show which of the following?? 
  {'A': 'Paresthesia over the anterolateral part of the thigh', 'B': 'Nail pitting and separation of the nail from the nailbed', 'C': 'Tenderness at the Achilles tendon insertion site', 'D': 'Ulnar deviation of the fingers bilaterally', 'E': 'Erythema and inflammation of the conjunctiva'},