A 20-year-old Male with Back Pain

A 20-year-old, previously healthy, white male, presented with low back and right fl ank pain for 2 weeks. The pain was varying in intensity from moderate to severe and diffuse and radiating to the groin, with no exacerbating or relieving factors and minimal relief with ibuprofen. He said the pain started after he was in a high velocity motor vehicle accident. According to the patient, his car was hit from behind by another vehicle, which resulted in skidding and the patient’s car landing upside down. There was no loss of consciousness. The patient was evaluated by the emergency medical system after the accident and was discharged after a computer-