A 66-year-old male patient is referred to physical therapy for low back pain that has been exacerbated over the past 7 days.    The patient describes the pain as deep and boring in the mid lumbar region.  The patient has an ankle-brachial index of 0.8 and reports that his lower extremities have been “colder than usual.”  Additional examination is LEAST likely to display which of the following signs or symptoms?

1. Bounding pulse in lower extremities
2. Pain radiating to the chest and scapulae
3. Pain unrelieved with positional changes
4. Pulsating abdominal mass

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