Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents with progressive right thigh pain, localized to the mid-femoral shaft, exacerbated by weight-bearing and movement. No history of trauma. Associated with nocturnal pain and functional limitation. Systemic symptoms include unexplained weight loss, fatigue, and night sweats. No history of known primary malignancy.
Clinical Examination Findings
Physical examination reveals localized tenderness and palpable fullness over the right femoral shaft. Range of motion of the right hip and knee is restricted due to pain. Neurovascular status of the right lower extremity is intact, with palpable distal pulses and normal capillary refill. No pathological fractures noted on initial inspection.
Treatment Protocol
Immediate plan includes orthopedic oncology consultation, weight-bearing restriction (non-weight bearing on right leg), and pain management with analgesics. Diagnostic workup initiated: CT chest/abdomen/pelvis, PET/CT scan, and serum tumor markers to identify primary malignancy. Consider biopsy of the femoral lesion for histopathological confirmation and immunohistochemistry.