Metastatic disease masquerading as mechanical low back pain; atypical symptoms which may raise suspicion

Clinicians working in spinal clinics and outpatient environments are confronted with the possibility of identifying patients with serious pathology causing back pain. Spinal metastatic disease is the most prevalent serious pathology seen in non-surgical spinal clinics, with breast cancer being the most common cause of spinal metastases in women. This case report describes the assessment and treatment of a patient presenting with low back pain radiating into the abdomen and bilateral anterior thigh pain, which was metastatic in origin. The case emphasizes the importance of early detection of metastatic disease, and identifies symptoms that could help to raise the index of suspicion for the clinician.