Anaemia, Pain and Ankle Weakness

A 69-year-old female with a history of rectal adenocarcinoma 7 years ago and subsequent surgery, radiotherapy and chemotherapy presented with complaints of numbness, pins and needles, and weakness in both legs. There was longstanding lymphoedema in both legs (consequence of previous treatment). These symptoms were so severe that they caused frequent falls. The patient reported that her current symptoms began with foot drop on the left 2 months ago, and later progressed to plantar flexion weakness (at the time of examination, she was unable to move her left ankle properly). There was also discomfort in her left leg, including her big toe (numbness, pins and needles). Despite using an ankle splint, she was walking slowly and gait seemed antalgic (affected by pain).