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Paget's Disease In A Patient With Thigh Pain - Page #1
 

Author: Kamalpreet Buttar, MD
Co Author #1: Jeffrey B Roberts, MD CAQ

Patient Presentation:
52 year old male presents with intermittent left thigh pain for 2 months. Symptoms became constant 2 weeks prior to evaluation.

History:
Patient reported 7/10 pain, localized to anterior and lateral thigh.
Pain is described as sharp, burning, and cramping in character.
Worse with weight bearing and at nighttime.
Percocet 5-325 and Naproxen 500 mg provide some relief.
There is a history of a Motor vehicle accident, one month prior to presentation with subsequent non radicular lumbar pain.

Physical Exam:
General: Obese, alert and oriented x 3. no acute distress
Left Thigh: mild tenderness to palpation of femur laterally. No swelling or redness. Full range of motion. Good strength of hamstrings and quadricep muscles. No atrophy or mass compared to contralateral extremity.
Left Hip: flexion 60 degrees, abduction 40 degrees, decreased internal rotation and external rotation with pain.

Click here to continue. Challenge yourself by writing down a broad differential diagnosis before moving to the next slide.

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