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Review of Clinical Signs Review Questions

Clinical Signs of Low Back Pain

Author: Bernard Karnath, MD

1. A 30-year-old man presents with acute onset of low back pain that radiates into the right leg. On physical examination, the patient has sensory deficits of the lateral leg and weakness of dorsiflexion of the foot and toes. Which of the following is the most likely diagnosis?

  1. L3 radiculopathy
  2. L4 radiculopathy
  3. L5 radiculopathy
  4. S1 radiculopathy
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2. A 30-year-old woman presents with acute onset of low back pain that radiates into the left leg. On physical examination, the patient has sensory deficits of the posterior thigh with weakness of eversion and plantar flexion of the foot. The patient also has diminished ankle reflexes. Which of the following is the most likely diagnosis?

  1. L3 radiculopathy
  2. L4 radiculopathy
  3. L5 radiculopathy
  4. S1 radiculopathy
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3. A 60-year-old man presents with progressive low back pain. He also describes bilateral leg pain with prolonged walking or standing. The pain is aggravated when walking uphill and relieved by rest or flexion of the back. What is the most likely etiology?

  1. Ankylosing spondylitis
  2. Herniated nucleus pulposus
  3. Spinal compression fracture
  4. Spinal stenosis
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4. A 20-year-old man presents with sudden onset of low back pain located on the left side, which radiates into the left inguinal region. The patient is writhing in pain and cannot find comfort in any position. He is afebrile. What is the most likely etiology?

  1. Discitis
  2. Disk herniation
  3. Nephrolithiasis
  4. Ruptured aortic aneurysm
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5. A 70-year-old woman with a history of breast cancer presents with a 2-month history of worsening progressive low back pain. The back pain is unrelieved by rest and worsens at night. What is the most likely etiology?

  1. Metastatic malignancy
  2. Osteoarthritis
  3. Osteomyelitis
  4. Spinal stenosis
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