Back pain Medical Question

Back pain Medical Question

A 71-year-old man comes to the emergency department with worsening back pain for the past 4 days. He underwent surgery for advanced prostate cancer 7 months ago. He states that he has fallen 4 times since yesterday due to imbalance. The patient’s temperature is 37C (98F), blood pressure is 125/82 mmHg, pulse is 84/min and respirations are 17/min. On physical examination his lower extremities strength is 4/5 bilaterally with mild spasticity and 3+ deep-tendon reflexes. Rectal sphincter tone is weak. He has point tenderness over the L5 & S1 region. Which of the following is the most appropriate next step in management of this patient?

Elderly patient with back pain

A- Leuprolide
B- X-ray of lumbar spine
C- IV glucocorticoids
D- NSAIDs and baclofen
E- Radionuclide bone scan





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