Editor’s note:
The Case Challenge series includes symptoms that are difficult to diagnose, some of which are not frequently encountered by most clinicians, but are still important to accurately recognize. Test your diagnostic and treatment skills using the following patient scenarios and corresponding questions. If you have a case you would like to submit for an upcoming Case Challenge, please contact us.
background
A 70-year-old man who received radiation therapy for stage I disease. prostate cancer For the past 8 years, I have been suffering from progressive leg pain and muscle weakness for the past 2 years. His symptoms began with severe midline low back pain; urinary incontinence, buttock allodynia. A month later, a shooting pain developed down his left leg and into his left foot. Two months later he completely lost sensation up his thighs. Six months later, he had muscle atrophy below his left knee with both proximal and distal muscle weakness requiring crutches to walk. At that time, he noticed similar symptoms in his right leg.
After a year, he could no longer sit without support. Additionally, he has unintentionally experienced his 50 lb (22.68 kg) weight loss, continues to have severe leg pain below both of his knees, and has complete bowel and bladder incontinence requiring adult diapers. was suffering from.
He reports no symptoms above the waist and no difficulty swallowing or breathing. Urological tests ruled out recurrence of prostate cancer.
His past medical history includes: radiation-induced cystitis A stent had to be placed.His family history is related to stroke His mother had symptoms but no other neurological conditions. He has a history of smoking 10 packs a year. He quit 40 years ago. He drinks one glass of wine a day and does not use illegal drugs.
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The views expressed above are the author’s own and do not necessarily reflect the views of WebMD or Medscape.
I quote this: Xuan Kang. Butt pain and incontinence – medscape – February 1, 2024.