Case presentation A 40-year-old man presents to his general practitioner with lower back pain, radiating down upto his right leg. The pain started while lifting a wardrobe in the bedroom. Since then, his foot feels ‘strange,’ and he holds it every time he walks upstairs. PMH : None Examination Vital signs are normal. Abdominal examination reveals a palpable mass in the suprapubic region. Examination of the lumbar spine is normal. The power in his legs is reduced, with the weakness of ankle dorsiflexion and the extensor hallucis longus.
He has reduced pinprick sensation over the lateral aspect of his right foot. The sensation around his perineum is abnormal. He has an absent ankle reflex on the right. A digital rectal examination reveals reduced anal tone. His pedal pulses are palpable. What is the most likely diagnosis for this patient? (Answer is posted in the comment section below!)…
