In elderly individuals one must also consider the possibility of compressive neuropathy in the back or pelvis secondary to occult malignant disease. He has not noted any back discomfort. He says there has been some aching at the junction of the right buttock and proximal thigh in the area of the sciatic notch. There is no family history of neuromuscular diseases. With exception of oral medication being taken for the diabetes, there is no additional significant medication history.
Social history reveals that the patient is retired from an automotive job many years ago.
He spends most of his days working in the garden. Approximately 3 months ago he and his wife purchased a stationary exer-cycle which he has been riding for up to 2 hours per day. If necessary, revise your differential diagnosis based on the additional clinical history. II Non-insulin dependent diabetes mellitus may be associated with a polyneuropathy depending on the level of glucose control. The lack of back pain goes against a compressive disc lesion.