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

Clinicians working in spinal clinics and outpatient settings are faced with the possibility of identifying patients with serious pathology causing back pain. Spinal metastatic disease is the most common serious pathology seen in non-surgical spinal clinics, with breast cancer being the most common cause of spinal metastases in women (Van Goethem et al., 2004). 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. This case highlights the importance of early diagnosis of metastatic disease, and identifies symptoms that may help to raise the index of suspicion for the clinician.