ABSTRACT
A 71-year-old man has been brought to hospital by his daughter, in a confused state. He was unable to give any history to the doctors. His daughter has told the staff that he mentioned becoming increasingly constipated over recent weeks but seemed to be well otherwise. He had generalized aches and pains that had been bothering him, but attributed them to arthritis, although his GP had arranged a bone scan (see Fig. 74.1) and protein electrophoresis (see Fig. 74.2) to investigate this further. When she visited him earlier in the day he was lying in bed, distressed and with obvious pain in his left arm. He was orientated to person but not time nor place.
