Question

question 8 (mandatory) (2 points)
a 65 year old male patient presents with a complaint of sudden right sided low back pain that came on while loading the grocery bags in the car last night. he explains the pain as \sharp and shooting pain\ that travels down the right leg. he grades the pain 7/10 on oswestry (low back pain questionnaire) which goes up to 9/10 when he coughs. as you observe his gait you notice a right antalgic lean. which of the following is the most likely diagnosis for this patient?
a) lumbar sprain/strain
b) posteromedial disc herniation
c) right erector spinae muscle spasm
d) posterolateral disc herniation

Explanation:

The patient has sudden low back pain with radicular (shooting) pain down the right leg, antalgic lean, and pain worsening with cough (increased intrathecal pressure). Posterolateral disc herniation (option d) typically causes radicular pain by compressing a spinal nerve root, matching the symptoms. Lumbar sprain/strain (a) and muscle spasm (c) usually lack radicular pain. Posteromedial herniation (b) often causes central canal stenosis - like symptoms (e.g., bilateral leg pain, gait disturbance) rather than unilateral radicular pain.

Answer:

d) Posterolateral disc herniation