A 22-Year-Old Man Comes to the Office Due to 3

question 775

Multiple Choice

A 22-year-old man comes to the office due to 3 months of progressive back pain.  He has also had intermittent subjective fever.  The patient emigrated from Nepal for a master's program 6 months ago.  He has no other medical conditions, takes no medication, and does not use tobacco, alcohol, or illicit drugs.  Temperature is 38.3 C (100.9 F) , blood pressure is 122/78 mm Hg, and pulse is 84/min.  BMI is 19 kg/m².  Tenderness is noted over the lumbar spine; flexion, extension, and rotation of the spine are limited due to pain and muscle spasm.  MRI of the lower spine reveals partial destruction of the anterior portion of the L1-L3 vertebral bodies and a fluid collection beneath the anterior longitudinal ligament.  Which of the following is the most likely diagnosis?

• A)Hodgkin lymphoma
• B)Osteosarcoma
• C)Rhabdomyosarcoma
• D)Staphylococcus aureus infection
• E)Tuberculosis