A 70-year-old male with a history of prostate cancer presents with severe back pain that radiates to his right leg. He also reports weakness in the right leg. What should be the main concern and how should this be investigated?
Given this patient's history of prostate cancer, the concern would be metastasis to the spine causing compression of the sciatic nerve and thus sciatica-like symptoms. This should be investigated with imaging, starting with an X-ray and possibly followed by an MRI or CT scan. Bone scans or PET scans may also be useful in identifying metastases.