The Curious Case of a Glioblastoma Disguised as Lumbar Pathology in Orthopaedic Physical Therapy Practice

Abstract

BACKGROUND: Glioblastoma is a primary brain tumor that shares symptoms with orthopaedic conditions like low back pain with radiating pain. The purpose of this case study was to describe a patient referred to physical therapy (PT) and subsequently diagnosed with a glioblastoma. CASE PRESENTATION: A 64-year-old male was referred to PT with right foot numbness and lower back pain. Initially, the patient was diagnosed with chronic low back pain with radiating pain (International Classification of Diseases and Related Health Problems, 10th Revision) related to lumbar spinal stenosis, and initial treatment resulted in significant reduction of foot numbness. After initial improvement, he reported an insidious onset of fasciculations and lacked response to therapy interventions, which warranted referral for imaging. OUTCOME AND FOLLOW-UP: Magnetic resonance imaging of the brain revealed high-grade glioblastomas, and the patient underwent a craniotomy for tumor resection with subsequent chemotherapy and radiation. DISCUSSION: Glioblastoma is an underreported condition in PT literature, and increased awareness of symptoms can improve recognition and appropriate referral. JOSPT Cases 2023;3(4):219-226. Epub 25 September 2023. doi:10.2519/josptcases.2023.11913