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We report a case of oncogenic osteomalacia that resulted in a disabling quadriparesis and multiple fractures before recognition of this treatable metabolic bone disease.
Case report.
A 61-year-old man presented with generalized weakness, muscle wasting, and diffuse bone pain of 7 years' duration. His symptoms began with gradual onset of hip flexor weakness and hip pain. Two years after onset, he required the assistance of a rolling walker, and within 4 years, he became wheelchair bound and had developed weakness of his shoulder girdle and arms. Prior outside neuromuscular evaluation revealed no specific diagnosis. Electrodiagnostic studies were normal, and muscle biopsy demonstrated type 2 fiber atrophy. Despite physical therapy, he progressed to dependence in all activities of daily living. He later developed multiple spontaneous fractures and diffuse pain of his shoulders, ribcage, and hips.
Neurologic examination 7 years after onset revealed diffuse atrophy without fasciculation of both upper and lower extremities and thoracic paraspinal muscles. Although muscle strength testing was painful, he was found to have a quadriparesis …
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