Dorsal Scapular Osteochondroma in the Chiropractic Clinic: A Case Report and Literature Review.

Osteochondromas are benign bone tumors that occur only rarely in the scapula. We report a case of an eight-year-old boy with dorsal scapular osteochondroma that initially presented as middle back pain, scoliosis, and a winged scapula. Unlike in most reported cases, the patient did not report severe pain. The chiropractor reviewed his previous radiograph and ordered a computed tomography scan, which revealed a bony mass on the dorsal aspect of the left scapula consistent with an osteochondroma. Given the patient's age and lack of symptoms, a conservative chiropractic treatment plan, focusing on posture, flexibility, and close monitoring, was adopted. Scapular mobilization, spinal adjustment, and a tailored exercise program provided symptomatic relief from scoliosis and improved mobility. Follow-up evaluations revealed further enlargement of the osteochondroma without accompanying symptoms. This study highlights the importance of considering a broad range of differential diagnoses in pediatric patients with atypical or unclear presentations. This study also demonstrates the potential benefits of conservative chiropractic management in patients with osteochondroma-induced musculoskeletal issues.

Non-surgical Restoration of L3/L4 Disc Herniation.

We report the case of a 52-year-old Asian man presenting with severe lower back pain and bilateral radiculopathy due to acute L3/L4 disc extrusion, causing severe spinal canal stenosis and bilateral L4 nerve root compression. Following a ten-week conservative management plan consisting of high-velocity, low-amplitude spinal manipulation, adjunctive therapies, and home exercise, the patient experienced significant pain relief, functional improvement, and near resolution of deficits. A six-month follow-up MRI revealed the resolution of the L3/L4 disc extrusion, and the patient remained asymptomatic at nine months. This case highlights the potential for spontaneous resorption of a lumbar disc herniation and symptomatic improvement with conservative management, including chiropractic treatment. A favorable natural course of a disc herniation should be considered when deciding between early surgical intervention and conservative management, warranting further prospective studies to evaluate the effectiveness of chiropractic treatment and the role of spontaneous regression in symptomatic lumbar disc herniation.

Sporadic Desmoid Tumor Mimicking Myofascial Pain Syndrome in a Chiropractic Clinic.

Chiropractors are primary healthcare providers who diagnose and manage various health conditions, including rare cases like desmoid tumors. Desmoid tumors are locally aggressive soft-tissue tumors originating from fibroblasts. This report presents the case of a 30-year-old woman who initially sought chiropractic care for persistent neck pain that was later discovered to be a symptom of a sporadic desmoid tumor. The patient presented with severe right upper neck pain, which was diagnosed as myofascial pain syndrome and yielded no significant improvement after various treatments. Physical examination by a chiropractor revealed a soft-tissue mass in the right upper trapezius and rhomboid region. In addition, magnetic resonance imaging revealed an intramuscular lesion measuring 8 × 4 cm in the right rhomboids, and subsequent biopsy confirmed the diagnosis of a sporadic desmoid tumor. The patient underwent successful surgical excision of the tumor. Postoperatively, the chiropractor initiated a comprehensive 12-week rehabilitation program that significantly improved the patient's range of motion and muscular strength and alleviated pain. The remarkable aspect of this case was the location of the tumor in the right rhomboid muscle, a less common site for desmoid tumors. This case underscores the crucial role of chiropractors as primary healthcare providers in the early detection of oncological cases and management of post-surgical rehabilitation.

Secondary Holocord Syringomyelia Associated With Spinal Hemangioblastoma in a 29-Year-Old Female.

Syringomyelia is a neurological condition characterized by the presence of fluid-filled cavities within the spinal cord, resulting in progressive neurological deficits. Secondary holocord syringomyelia, a rare manifestation in the entire spinal cord, is associated with spinal hemangioblastomas. We report the case of a 29-year-old female who presented with neck and bilateral upper limb pain and numbness. She was diagnosed with secondary holocord syringomyelia associated with a spinal hemangioblastoma and underwent conservative management. Magnetic resonance imaging plays a critical role in diagnosing neurological conditions. The management of spinal hemangioblastomas and syringomyelia can be challenging and requires a multidisciplinary approach to patient care. In this report, we discuss the clinical presentation, diagnosis, and management of a patient with secondary holocord syringomyelia associated with spinal hemangioblastoma.