This man presented to the Accident and Emergency Department late one night having become inebriated and picked a fight. He was kicked to the ground and stamped upon by his assailants. He complained of a pain over his back.

On examination there was a large swelling in the region of the thoracolumbar junction. Neurological examination was entirely normal - indeed after the examination he attempted to assault several members of staff and was wrestled to the ground!

Look at the AP and lateral views of his lumbar spine. What abnormalities do you see? What further investigation might you request?

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