06-09-2007, 08:44 PM
A 22-year-old man who is a recent immigrant from Pakistan comes to the emergency department because of a shock-like sensation in his left thigh on forward flexion. His left leg becomes fatigued easily. He has a fever and has been losing weight. He was treated for tuberculosis for a long time in his country but was noncompliant with the medications. Neurological examination demonstrates lower extremity paraparesis. An MRI of the spine reveals collapsed vertebrae at the level of T11 to L1. Which of the following is the most appropriate next step in his management?
(A) Start nafcillin
(B) Lumbar puncture
© Orthopedic consultation
(D) Bone scan
(E) Immediate radiotherapy
(A) Start nafcillin
(B) Lumbar puncture
© Orthopedic consultation
(D) Bone scan
(E) Immediate radiotherapy