Anatomy clinical correlates Quiz: Ace Your Exams

A 72-year-old man comes to the clinic for evaluation of lower back pain. The pain began four weeks ago, is present throughout the day, and awakens him at night. The patient does not have a history of recent trauma, weakness, or paraesthesias. He does not note any significant changes to the pain with standing or sitting. Past medical history is significant for hypertension. Medications include lisinopril and atorvastatin. The patient smokes 2-3 packs of cigarettes daily and has done so for 36 years. He does not use other recreational drugs or alcohol. Temperature is 37.0°C (98.6°F), pulse is 90/min, respirations are 20/min, and blood pressure is 120/75 mmHg. He is awake and oriented to time, place, and person. Tenderness is noted at the L1-L2 vertebral level. Examination of the external genitalia is noncontributory. Neurological examination reveals normal muscle strength and normal sensory findings. Rectal examination reveals an asymmetric non-tender nodule in the prostate. Straight leg raise testing is negative bilaterally. Which of the following is likely to be found upon further evaluation?