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A 36-year-old man comes to an urgent care center reporting pain in his back that began the previous day. The pain is sharp and worse with certain changes in position. He does a lot of lifting at his job stocking shelves in a grocery store, but he cannot relate the onset of the pain to any specific lifting that he has done.

View the image taken (Figure 1) and consider what your diagnosis would be.

Clinical Challenge: March 2016