Back Pain - Metastatic Disease

44, male C/o: 2 month history of central lower back pain. Insidious onset Worse with lying / night time. Also worse first thing in the morning. Wakes up 2-3 times per night due to pain. Social Office Job Active Life style Enjoys playing sport Ex smoker (stopped 12 years ago) Weekend drinker Past medical history of Crohn's disease No weight loss No [...] Read more

Plasmacytoma | Cases

Retrospective case study 66 Male 1 year history of right thigh pain Attended physiotherapy. Given exercises for tight thigh muscle. No improvement. Consulted GP 10-12 months after physiotherapy as he developed problems with sit to stand. GP requested X-ray pelvis. X-ray report as follows. GP referral for x-ray mentions – “Injury right leg two [...] Read more

Lung Cancer | Pancoast

71 male First appointment 3 Month history of Right rhomboid pain. Aggravated by shoulder movements. Struggles to get to sleep and occasionally wakes up. No P+N or numbness. No dizziness, diplopia, dysarthria, dysphagia, drop attacks, nausea. Exam Slight winging right scapula. Full shoulder ROM Full shoulder strength Provisional Diagnosis [...] Read more

Back Pain | Ankylosing Spondylitis | Cases

26 ♂ Presented to MSK service with back pain. Gave a 7 year history of back pain (started aged 19) Seen previously in MSK service 5 years ago (aged 21). Had an MRI scan which was normal. Has has physiotherapy in the past. Has been regularly having chiropractic treatment. Reports that his back remains arched when he is lying supine (lordosis [...] Read more

Bony Mets – No Primary | Cases

Skeletal Metastases of Unknown Primary – SMUP Presentation 64 male, Retired, likes walking. C/o: Right sided lumbosacral pain. No reported P+N or Numbness. Onset – 6 weeks, insidious. Ongoing left knee issue. Patient reports the onset of back pain was gradual. He linked it to the knee pain due to compensatory gait. Pain worse with sustained [...] Read more