67: MULTIPLE MYELOMA

PATIENT PRESENTATION

A 62-year-old female that is retired, complains of a recent onset of left-sided back pain that radiates from her left lower scapula area down the left side of her back and into her left leg. The pain began about 5 weeks ago after she was hospitalized for pneumonia. She was admitted for 3 weeks. She did not receive her monthly chemotherapy treatment during this time. The pain is worse when she does activities that require her to use her arms. She describes it as aching pain in the middle back and she feels weak and stiff in the lower left side of her back and left thigh. She lives alone, however, has a caregiver who assists as need. She is able to perform her self-care independently; however, she is not able to vacuum, sweep, or mop, as these activities increase her pain.

The patient has a moderately kyphotic posture with a flattened lumbar curve. The thoracic and lumbar paraspinals are tight with greater tightness in the right thoracic paraspinals. Strength is WNL in bilateral UE except for left scapular muscle weakness. She has LE weakness in left hip muscles (abduction and extension), as well as bilateral ankle plantar flexion (PF). She is unable to perform unilateral heel raise on right or left. She complains of increased pain with UE and LE testing. The pain complaint was greater with UE testing, particularly shoulder MMT. She presents with postural ...