Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents with [site] pain, sudden in onset, following minimal or no trauma. History significant for known Multiple Myeloma, currently [on/off] therapy. Pain is [constant/intermittent], exacerbated by movement, and unresponsive to conservative analgesia. No associated neurological deficits, bowel/bladder incontinence, or constitutional symptoms (fever, night sweats) reported.
Clinical Examination Findings
General: Patient appears [distressed/comfortable], guarding [site]. Musculoskeletal: Localized tenderness, swelling, and crepitus noted at [site]. Range of motion significantly limited due to pain. Neuro: Distal neurovascular status intact; sensation and motor strength [grade] in extremities. No signs of spinal cord compression or radiculopathy.
Treatment Protocol
1. Immobilization of the affected site (brace/splint). 2. Analgesia optimization (multimodal approach). 3. Urgent orthopedic/neurosurgical consultation for stabilization/fixation. 4. Oncology review for systemic therapy adjustment (proteasome inhibitors/IMiDs). 5. Bone-modifying agents (bisphosphonates/denosumab) as indicated. 6. DVT prophylaxis.