A 42-Year-Old Woman With Chronic Leg and Lower Back Pain

John G. Christensen, Jr, MD

Disclosures

April 10, 2017

Editor's Note:
The Case Challenge series includes difficult-to-diagnose conditions, some of which are not frequently encountered by most clinicians but are nonetheless important to accurately recognize. Test your diagnostic and treatment skills using the following patient scenario and corresponding questions. If you have a case that you would like to suggest for a future Case Challenge, please contact us.

Background

A 42-year-old woman presents with a history of chronic leg and lower back pain lasting several years. She has no history of flank pain or gross or microscopic hematuria. She does not report any fevers, appetite loss, weight loss, or obesity.

She is a nonsmoker and drinks a glass of wine with dinner 2-3 nights a week. She works as an office assistant and is not exposed to any solvents or chemicals. Her medical history is free of chronic illness, and she has no family history of renal tumors, skin lesions, seizures, or cognitive delay.

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