A 78-year-old man presented with the chief complaint of new-onset low back pain. The patient had metastatic prostate cancer, which was diagnosed 2 years ago, and a solitary asymptomatic bone metastasis in the right pubic bone. To date, he had been managed with androgen deprivation therapy alone. His performance status was good, and his prostate-specific antigen (PSA) level was stable. Past medical history : Hyperlipidemia and atrial fibrillation Past medication history: He was on atorvastatin and warfarin.
Allergies: None Social history: Non-smoker and Non-alcoholic He reported a 6-week history of constant, burning pain in the lower lumbar region, which was worse at night and was 7/10 in severity on the Numeric Pain Rating Scale. He had no relief with regular paracetamol or ibuprofen. He had not had lower limb weakness, numbness, lower urinary tract symptoms, or weight loss. Which…
