Case 214

Case 214

Enunciado

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.



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

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