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Unusual Bone Manifestations of a Common Disease

Walther T. Weylman, M.D.; Harold Simon, M.D.
JAMA. 1961;177(12):855-857. doi:10.1001/jama.1961.73040380020006.
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Dr. Nathan T. Griscom: A 74-year-old woman was admitted to the Massachusetts General Hospital on Dec. 6, 1960, because of pain in the left foot and ankle. Two months before admission she began to have pain in the left heel, which spread to the entire foot, completely restricting ambulation. She also began to notice some generalized weakness and loss of appetite. X-ray films obtained elsewhere approximately a month before admission supposedly showed only a bony spur on the calcaneus. She twisted her left ankle on the day of admission.

Her history revealed an abdominoperineal resection for carcinoma of the rectum 2 years earlier. This proved to be a Grade 3 adenocarcinoma with 1 of 11 nodes positive. She had had viral pneumonia 2 or 3 months before this present episode. Thirty years previously she had had a needle fragment in her foot which was removed after lodging there for some


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The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
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