A subtle change can give the diagnosis

A 60-year-old man had a diagnosis of small cell lung cancer. He started with a strong pain on his right leg but no clear evidence of bone metastases was present…..

CLINICAL CASE: The pain was so strong that morphine has to be administered to take an X-Ray. No bone fracture was present and pain-killers were prescribed.

EVOLUTION:  No clear improvement was obtained and the patient has to remain  on bed most of the time. Three weeks later the patient felt something like a “sound” inside his leg with an increase in pain. A new X-ray showed a pathological bone fracture.

COMMENTS: The initial x-ray showed some spots at the same place of the fracture location. Sometimes subtle changes can give you the diagnosis and the possibility of suffering reduction.