He denies any weakness or sensory changes in his legs

A 42-year-old male presents to your office complaining of back pain that started two days ago after carrying heavy packages. He denies any weakness or sensory changes in his legs. His past medical history is insignificant. He is not taking any medications and denies drug abuse. His temperature is 36.7 C (98 F), blood pressure is 120/76 mmHg, pulse is 80/min, and respirations are 16/min. Physical examination reveals paravertebral tenderness. Lower extremity power is 5/5 and the deep tendon reflexes are 2+. Babinski’s sign is negative. Straight-leg raising test is negative at 90 degrees. What is the most probable diagnosis in this patient?

A. Multiple myeloma

B. Ankylosing spondylitis

C. Compression fracture of the vertebrae

D. Lumbosacral strain

E. Herniated disk