back pain

A 70-year-old male presents to his general practitioner complaining of mild, chronic lower back pain that has been present for several months. He describes the pain as a dull ache, worse with prolonged standing. He has a significant past medical history including hypertension, hyperlipidemia, and a 50-pack-year smoking history, all of which are currently managed with medications. He denies any acute abdominal pain, pulsatile sensation, or leg symptoms. On physical examination, his vital signs are stable: blood pressure 135/85 mmHg, heart rate 72 bpm, respiratory rate 14 breaths/min, and oxygen saturation 99% on room air. Abdominal examination is soft, non-tender, with no palpable masses. Peripheral pulses are symmetric and strong. As part of the investigation into his chronic back pain, a contrast-enhanced CT scan of the abdomen and pelvis is performed. An axial view from the scan is shown. Based on the clinical presentation and the findings demonstrated in the provided image, which of the following is the MOST appropriate next step in management?

A 70-year-old male presents to the emergency department with severe abdominal and back pain. He has a history of hypertension and smoking. On examination, he is hypotensive and tachycardic. Palpation reveals a pulsatile abdominal mass. What is the most likely diagnosis?

A 4-year-old presents with abdominal distension and back pain for 2 months. Exam reveals a firm, fixed abdominal mass. Vitals are normal. An abdominal CT is performed (axial view shown). Which lab finding would MOST strongly support the suspected diagnosis?

A 60-year-old woman with a history of breast cancer, treated with surgery and radiation 5 years ago, presents with new-onset back pain. Imaging reveals lytic lesions in the spine. What is the most likely diagnosis?

A 72-year-old male presents with new onset back pain. His CT is shown. What is the most appropriate initial management?

A 4-year-old presents with abdominal distension and back pain for 2 months. Exam reveals a firm, fixed abdominal mass. Vitals are normal. An abdominal CT is performed (axial view shown). Which lab finding would MOST strongly support the suspected diagnosis?

A 70-year-old male undergoes a CT scan for investigation of chronic back pain. He has no history of abdominal pain or pulsatile mass. His blood pressure is 130/80 mmHg. The image provided is an axial view from this scan. Based on this finding and the patient's clinical status, what is the most appropriate next step in management according to current guidelines?

An 80-year-old male with a history of smoking and hypertension presents to his GP with mild, intermittent lower back pain. Physical examination is unremarkable. Routine blood tests are normal. A CT scan of the abdomen is performed to investigate the back pain. Considering the findings demonstrated in the provided image in the context of this patient's presentation, what is the most appropriate next step in management?

A 70-year-old male undergoes a CT scan for investigation of chronic back pain. He denies abdominal pain or pulsatile mass. His blood pressure is 130/80 mmHg. The provided image is an axial view from this scan. Based on this finding and the patient's clinical status, what is the most appropriate next step in management according to Australian guidelines?