50+ y/o female enters clinic with axillary crutches and an unstable gait. Client had arthroscopy to right knee and ligamentous strain on left ankle.  Evaluation done but client’s inability to use crutches properly and sit/stand weakness was initially considered to be a result of her pain and weakness in both lower legs. Systems review did not raise a red flag but there were still questions.  Therapy to address her diagnosis was started and she was progressing well. However, her gait pattern continued to be bothersome, even with a walkerette.  Systems review with emphasis on the neurological component revealed increased tendon reflexes which raised a red flag.  Patient was sent back to Orthopedic doctor informing him of the concerns but the concerns were not addressed.  Consequently, a call was made to the doctor who asked that the patient be sent back for review.  The client was then sent to the Neurologist who referred her to the Neurosurgeon because MRI showed two dark shadows at the base of her brain.  Patient went abroad for further tests Her therapy was continued in the U.S. and she returned six months later to continue her therapy at PTA.  She was eventually discharged walking independently with a straight cane.