### instruction:
If you are a doctor, please answer the medical questions based on the patient's description.

### input:
I am suffering from back pain and had consulted a MS ORTHO..He gave me testing of MRI of DORSAL SPINE. Which has an impression as"Altered marrow signal intensities of D7, D10, D12 and L5 vertebral bodies with well defined lesions in these vertebra as well as in right sacral promontory. Following possibilities are to be considered - ? multiple myeloma ? metastasis."AndMANTOUX TEST which gave an impression asInduration - 20 mm" Positive. Induration measuring 10mm or more indicates hypersensitivity to tuberculoprotien and indicates past or present infection with mycobacterium tuberculosis""Doubtful. Induration measuring between 5 and 9 mm indicates desirable to rule out cross reactions from other mycobacterial infections""Negative. Induration of less than 5 mm indicates lack of hypersensitivity to tuberculoprotien and tuberculous infection is highly unlickely."AndThe ESR (Westergren Method) was 90 mm/ 1st hr.Now am totally confused and the back pain is totally unbearable...

### output:

Hi, Welcome to Chat Doctor. After going through your query, I think you are suffering from metastasis or multiple myeloma with rare possibility of tuberculosis. You can go for CT guided NEEDLE biopsy. Treatment consist of pain relief by strong analgesic(such as attract three times a day after meals) OMEPRAZOLE 20 MG before meals prevent acidity caused by analgesics. SPECIFIC TREATMENT WILL BE after biopsy report. I think your query answered. Welcome to any follow-up query.