Bronchogenic carcinoma presenting as neuromusculoskeletal pain.

A case of bronchogenic carcinoma manifesting Pancoast's syndrome is presented. A 48-year-old female patient suffered from pain in the neck, axilla, anterior lower ribs and subscapular regions, with thoracic paraspinal muscle spasm, and paresthesia in the right upper extremity. An anteroposterior lower cervical radiograph demonstrated a homogenous mass lesion in the apex of the right lung. The patient was referred for medical diagnosis and treatment. A significant reduction in the pain experienced by the patient was achieved with spinal manipulative therapy while the patient was undergoing medical therapy for the malignancy.

Unilateral intermittent claudication of the left lower extremity.

Numerous approaches including surgery for the release of cauda equina compression symptoms due to vertebral canal stenosis are well known. The successful use of spinal manipulative therapy for reduction of neurogenic claudication symptoms is discussed in this case presentation. An elderly male presents with vague leg pain and paresthesias of the left lower extremity precipitated by walking. A brief discussion of the etiology, symptomatology and diagnosis of claudication is made. Methods of differential diagnosis of vascular vs. neurogenic claudication are discussed.