Questions 1 and 2 are based on the following case:

A 71-year-old man with a history of hypertension and an elevated prostate-specific antigen (PSA) level that is under observation reports increasing low back pain to his primary care physician. The pain initially started as an ache, but over the past 2 months has reached a 7/10 level. The pain does not radiate. A trial of ibuprofen and physical therapy for 3 weeks does not relieve the pain. The patient is referred for magnetic resonance imaging (MRI) of the lumbar spine; an image on a coronal T2-weighted section from that evaluation is shown in the Figure. His primary care physician next orders a nuclear bone scan, which comes back negative.

^{Image used by permission of Tomer Mark, MD.}

Figure. T2-weighted image from magnetic resonance imaging evaluation of patient in question 1.