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A 48-year old female breast cancer survivor is admitted to the ED with chief complaint of upper lumbar pain described as an intermittent, variable, and dull ache without referral into the buttock or lower extremities. She had sought attention from her primary care physician but 10 sessions of Physiotherapy and NSAIDs failed to treat her. The pain is most intense in the evening and occasionally causes difficulty falling asleep. She also mentions an unintentional weight loss of 6 kg within the last two months. Presence of which of the following in the physical examination would justify ordering an Emergent MRI during this ED visit?