Dr. Eric Ezekiel, Fellow in Hematology, Jewish Hospital of St. Louis: A 56-year-old white woman was hospitalized because of severe, progressive pain in the right leg of six weeks' duration. The patient had been well until 17 months before admission when she first noted the onset of low back pain radiating to the right buttock and right thigh. There was no history of trauma, fever, chills, or anorexia.
Physical examination revealed a thin, middleaged white woman complaining of pain in both legs. Pulse rate was 86 beats per minute and regular; blood pressure, 120/80 mm Hg; and respiration rate, 14 per minute. Results of examination of the head, ears, eyes, nose, throat, chest, and abdomen were unremarkable. There was exquisite lumbosacral tenderness. Pinprick and position sense were diminished in both legs.
Laboratory data on admission included a hemoglobin value of 11.9 gm/100 ml and a white blood cell count (WBC)