Case presentation A 62-year-old healthy woman presented to a GP with complaints of irritability and confusion over the last 3–4 weeks. She reported events of forgetfulness on certain occasions. Furthermore, she had a 2-month history of non-specific back pain that had gradually increased in severity. The pain was maximal at the low thoracic area, and she had taken paracetamol and ibuprofen for the same.
There was no history of trauma; however, she noticed some abdominal discomfort and constipation related to the pain medicines. Physical examination The patient appeared a little pale. Absence of abdominal tenderness Presence of local tenderness over the lower thoracic spine Laboratory investigations Hemoglobin: 9.9 g/dL White cell count: 3.2 x 109/L Platelets: 112 x 109/L Sodium: 140 mmol/L Erythrocyte sedimentation rate (ESR): 96 mm/hr Potassium: 3.8 mmol/L Raised levels of serum calcium…
