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ACP InternistMKSAP Quiz: 1-year History of Lower Extremity Edema

The patient’s ankylosing spondylitis is poorly controlled. He has avoided biologics and is on naproxen only. Now his course is complicated by persistent lower extremity edema. Other than hypertension, his vitals are normal. His spine is kyphotic with reduced mobility. He has 2+ swelling in both legs. After reviewing the labs, suggest your diagnosis.

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