Question

A 45-year-old office worker presents with acute low back pain for 5 days after lifting a heavy box. There is no history of trauma, malignancy, weight loss, neurological deficit, or systemic symptoms. Examination is normal apart from paraspinal tenderness. According to Choosing Wisely Canada recommendations, what is the most appropriate imaging strategy?

Accepted Answer

No imaging at this time; provide conservative management and reassess if red flags develop or symptoms persist

Answer

Immediate lumbar spine MRI to rule out disc herniation

Answer

Immediate lumbar spine CT scan

Answer

Lumbar spine radiographs because he is older than 40 years

Answer

Bone scan to assess for malignancy

Practice question