Excerpt
A 39-year-old woman with breast cancer was admitted with progressive bilateral knee pain. Five years earlier, a 3.5 cm primary breast lesion was detected, including one positive axillary lymph node, and she received 4 cycles of chemotherapy. Three years before admission, metastatic disease was detected in the lumbar spine; additional chemotherapy followed.
She now presented with increasingly intolerable right greater than left knee pain, which was intolerable upon weight-bearing and ambulation. Medications included ibuprofen, oxycodone, pregabalin, and paroxitene. Examination revealed a sedated woman with alopecia. Temperature was 37.8°C. Heart, lung, and abdominal findings were unremarkable. There was no synovitis affecting…
