MRCP2-3058

MRCP2-3058

A 58-year-old male construction worker presents with sudden and severe lower back pain. He has no history of orthopedic issues and has been in good health until now. The patient reports experiencing tingling sensations in his lower limbs and has not been able to urinate since the onset of the pain. Upon neurological examination, weakness (3/5 of both lower limbs) and loss of sensation to touch in L4, L5, and S1 are observed. Vibration sensation and joint position sensation are intact, but reflexes in the ankles and knees are absent and the plantar response is uncertain. The patient’s blood pressure is 160/70 in his left arm and 152/64 in his right, heart rate is 96 bpm, temperature is 37°C, and ECG shows normal sinus rhythm with no signs of ischemia. The rest of the examination is unremarkable. What diagnostic test would be most helpful in determining the cause of the patient’s symptoms?