Review Question - QID 210960

A 25-year-old man presents to his primary care physician for pain in his back. The patient describes the pain as feeling worse in the morning. He says it is a general stiffness that improves when he goes to the gym and lifts weights. He also states that his symptoms seem to improve when he leans forward or when he is cycling. The patient is a current smoker and is sexually active. He admits to having unprotected sex with many different partners this past year. The patient has no significant past medical history and is not currently taking any medications. His temperature is 98.7°F (37°C), blood pressure is 115/67 mmHg, pulse is 82/min, respirations are 11/min, and oxygen saturation is 98% on room air. On physical exam, the patient demonstrates notable kyphosis of the thoracic spine and decreased mobility of the back in all 4 directions. The patient’s strength is 5/5 in his upper and lower extremities. The rest of his physical exam is within normal limits. Which of the following findings is associated with this patient’s presentation?