Case 214

Case 214


M.J.C., 71-year-old female, was diagnosed with cryptogenic cirrhosis 10 years ago, standard jaundice predominantly cholestatic, currently ranked B9 (Child-Pugh Score). Complains about moderate low back pain, predominantly mechanical, without radiation, which began a month ago, no history of previous trauma. In use of furosemide, spironolactone and lactulose. On examination: pallor +/4+, jaundiced 2+/4+, afebrile, lower limbs without edema. Painless abdomen without masses. Pain in the lumbar spine with worsening on palpation. It was requested a computed tomography (CT) of the thoracolumbar spine.

Image 1: Computed Tomography (CT) scan of the lumbar thoracic spine, sagittal cut, paramedian.

Considering the image and the clinical data, which of the alternatives below explains best the low back pain of the patient?