Metastatic Breast Cancer Presenting As Neck Pain in a Pregnant Patient.

Breast cancer metastasizing to the spine during pregnancy is a rare occurrence. A 36-year-old woman experienced persistent neck pain during the third trimester of pregnancy. The pain continued until the postpartum period, severely affecting quality of life (QOL). Physical examination revealed a restricted cervical range of motion. Spinal lesions were detected on magnetic resonance imaging. Metastatic breast cancer was confirmed through a biopsy. The patient underwent radiation therapy for spinal metastasis, chemotherapy for breast cancer, and nonsteroidal anti-inflammatory drug therapy for pain. She was referred for chiropractic care and physical rehabilitation. After six weeks of collaborative treatment, the patient experienced significant pain relief and improvement in strength, mobility, and QOL. This case report highlights the need to evaluate unexplained symptoms in pregnant and postpartum women to exclude sinister pathologies. It demonstrates the need for a multidisciplinary approach that combines oncological, chiropractic, and rehabilitative care to optimize the outcomes in patients with complex presentations.

Spondylodiscitis in a Patient Undergoing Chronic Peritoneal Dialysis Presenting to a Chiropractor: Case Report and a Review of the Literature.

Spondylodiscitis is a rare but severe condition characterized by spinal and paraspinal infections that will present to healthcare providers, including chiropractors, because of neck pain. Patients who undergo peritoneal dialysis for end-stage renal disease or have a complex medical history may present with musculoskeletal complaints with complicated and uncommon underlying causes. This report reviews the possible relationship between spinal infection and dialysis, as well as the role of the chiropractor in identifying and managing critical conditions. A 66-year-old Asian man undergoing peritoneal dialysis presented to a chiropractic clinic with pain in the left arm. The patient did not present with a fever. Upon examination, the upper limb muscle strength and reflexes were diminished. Neck pain was also experienced during the range of motion examination, and movement was limited in all directions. Magnetic resonance imaging was ordered. The patient was diagnosed with acute spondylodiscitis. Due to its nonspecific presentation, patients with severe and urgent cases, such as spondylodiscitis, may present to chiropractic offices to seek conservative treatment of pain symptoms. This report highlights the potential role of chiropractors in the early detection and management of complex conditions such as spondylodiscitis in patients on chronic dialysis.

Fifth Distal Phalanx Avulsion Fracture in a High-Level Marathon Runner.

Fifth metatarsal fractures are common foot injuries that involve the long bone on the outer side of the foot, and avulsion fractures involving the short bone and the fifth distal phalanx of the foot have never been reported. A 25-year-old female marathon runner sustained an avulsion fracture of the distal lateral phalanges of the fifth metatarsal. The patient's high functional demands necessitated a conservative approach to minimize complications and facilitate efficient fracture healing. The patient underwent a comprehensive chiropractic rehabilitation program that focused on progressive weight-bearing exercises, range-of-motion activities, strengthening exercises, instrument-assisted soft tissue mobilization (IASTM), therapeutic ultrasound, and laser therapy to stimulate the speed of healing. The patient's progression was closely monitored throughout the rehabilitation process. Because of the nonoperative management and chiropractic rehabilitation, the patient successfully returned to her running activities within a six-week duration. This case demonstrates the effectiveness of nonoperative management and chiropractic rehabilitation in promoting the healing of avulsion fractures of the fifth metatarsal in high-level athletes. This conservative approach can facilitate a safe and efficient return to running activities while minimizing complications and reinjury risks.