The immediate management and investigation of an acute endocrine presentation in general practice is discussed in this section. It is inspired by, but not based on, a real patient situation.
Lily, a 60-year-old shop assistant, presents with sudden onset of back pain after bending down to pick up a tray of mangoes at work. The pain is located in the mid-back and has not resolved after 48 hours of bed rest. On examination, she has acute tenderness in the midline, at the lower thoracic level. She is afebrile, has no systemic symptoms and neurological examination is normal.