Question

A 30-year-old man presents with acute low back pain after lifting a heavy box. Pain is localised to the lumbar area without leg radiation. He has no history of cancer, trauma, weight loss, fever, intravenous drug use or neurological deficits. Examination shows local tenderness but normal strength, reflexes and sensation. According to Choosing Wisely Canada, what is the most appropriate management regarding imaging?

Accepted Answer

Avoid imaging at this time and manage with analgesia and activity modification, reassessing if red flags develop or pain persists.

Answer

Order immediate lumbar spine MRI.

Answer

Order lumbar spine X-rays to reassure the patient.

Answer

Order CT scan of the lumbar spine urgently.

Answer

Refer urgently to neurosurgery for imaging and assessment.

Practice question