i think its x ray of back bone which shows some prob with lumber region vert. but also there are some intra luminal gases.can be a case of trauma or back bone prob
I don't know the clinical history of the patient, so I can't say if his problem is really an abdominal distension due to intra-luminal gas (and this is the clearest sign in this x ray). However in my opinion the sacroiliac joints are not normal: sclerosis, diastasis and erosion. can I guess sacroiliitis? in this case the differential diagnosis should be: ankylosing spondilitis vs. sacroiliitis in reactive arthritis (es. Reiter syndrome) vs. sacroiliitis in IBD-associated arthritis vs. sacroiliitis in psoriatic arthritis.