Given these changes from the original case, what is your diagnosis?
What is your diagnostic explanation?
As compared to the long case, this is a 25 year old overweight woman who reports low back pain for 2 days. The pain began when lifting her couch up a flight of stairs. Pain is reported to be 5/10 that increases to 7/10 when she coughs or sneezes. Pain radiates down the back of her left leg, has a burning quality, and is exacerbated by forward flexion activities like sitting, driving, and lifting. Pain is somewhat relieved by standing and walking. Patient does not report leg weakness, bladder dysfunction, numbness, or fever.
Physical exam: Musculoskeletal-inspection does not reveal any skin changes, edema, or deformity. Flexion, extension, and lateral flexion of spine are limited due to pain. Muscle strength is 5/5 bilaterally in upper and lower extremities. Patient has normal sensation and no neurological deficits throughout. Straight leg raise elicits pain down the back of the left leg. All other exam findings are within normal limits.