Answer the USMLE (Step 2CK) question(s) which are shown below, choose one answer from the multiple choices, and then check the correct answer by clicking on the get answer button.
Question
A 48-year-old man comes to the physician because of a 2-day history of severe low back pain. He states that he has periodic low back pain for years, but this is more severe than usual and radiates to the buttock and down the right leg. His temperature is 36.8 C (98.2 F). Examination shows some rigidity of the lumbar spine. The pain is exacerbated by applying pressure on the paravertebral region in the lower lumbar spine and by passively raising the leg at 45 degrees while the patient lies supine. A reduced Achilles tendon reflex is noted. Which of the following is the most appropriate next step in management?
A. MRI examination of vertebral column
B. Nonsteroidal anti-inflammatory drugs (NSAIDs) and 2 days of bed rest
C. Plain x-ray examination of the lumbosacral spine
D. Radionuclide bone scanning
E. Surgical consultation
