Splenic calcifications in a patient with Systemic Lupus Erythematosus: an imaging case review.

A 47-year-old female presented to a chiropractic clinic with known diagnosis of systemic lupus erythematosus. Radiographic examination demonstrated multiple splenic calcifications, an uncommon, yet important finding. The patient was subsequently referred to her primary care physician for co-management and further evaluation.

Une femme de 47 ans s'est présentée dans une clinique chiropratique avec un diagnostic connu de lupus érythémateux disséminé. L'examen radiographique a mis en évidence de multiples calcifications spléniques, une découverte peu commune mais significative. La patiente a ensuite été adressée à son médecin traitant pour une prise en charge conjointe et une évaluation plus poussée.

A Patient With Pancoast Tumor Presenting With Cervical Radiculopathy: A Case Report.

Objective: The purpose of this report was to describe a patient with a Pancoast tumor who presented for chiropractic care with neck and arm pain. Clinical Features: A 52-year-old male patient with right-sided cervicothoracic pain and numbness in the right upper extremity presented to a chiropractic office for care. The patient reported an occupational history of repetitive lifting motions and overuse injuries. The patient denied history of smoking at the time of presentation. Intervention and Outcome: Radiographic imaging revealed tracheal deviation. A chest computed tomography image demonstrated a large lesion in the apex of the right lung, suggestive of bronchogenic carcinoma. The patient was referred to an oncology clinic, where he admitted to having a 20-year history of smoking. The diagnosis of adenocarcinoma was made via biopsy, and the oncologist's evaluation confirmed the cancer to be stage IIIC. The patient received palliative care treatments, as the advanced state of his condition determined that he was not a candidate for surgical intervention. Conclusion: Chiropractors and other first-contact health care providers must keep in mind unusual presentations masquerading as common conditions. This case demonstrates the importance of including apical lung tumors in the differential diagnosis of unilateral arm and neck pain and neurologic deficits of the upper extremity. This case demonstrates the importance of thorough follow-up on images ordered, including the ordering clinicians viewing the images themselves.

Conservative management of neck and thoracic pain in an adult with neurofibromatosis-1.

OBJECTIVE: To describe the case of a 21-year-old female with previously diagnosed neurofibromatosis type 1 (NF1) with neck, scapular, lumbar, and temporomandibular discomfort along with headaches. CLINICAL FEATURES: The patient had chronic tightness and pain in the cervicothoracic region as well as pain in the lumbar spine at the site of prior neurofibroma removal. Radiographs demonstrated multilevel osseous changes. In addition to NF-1, she was diagnosed with cervical myalgia, tension-type headaches, and chronic temporomandibular joint disorder. INTERVENTION AND OUTCOMES: Treatment consisted of a course of manual therapy including cervical flexiondistraction, myofascial release, patient education on workplace ergonomics, and an at-home active care plan. The patient experienced a reduction in pain and headache frequency. SUMMARY: Manual therapy in the form of cervical flexion-distraction with myofascial release and education on workplace ergonomics were effective in reducing neck and thoracic pain as well as reducing headache frequency in a 21-year-old with NF-1.

OBJECTIF: Présenter le cas d'une jeune femme de 21 ans atteinte de neurofibromatose de type 1 (NF1) et ressentant une gêne au cou, aux épaules, à la région lombaire, à l'articulation temporomandibulaire et souffrant de maux de tête. CARACTÉRISTIQUES CLINIQUES: La patiente se plaignait de raideurs chroniques et de douleurs à la région cervicothoracique et à la colonne lombaire au point d'ablation d'un neurofibrome. Les clichés radiographiques montraient des altérations osseuses à plusieurs étages. En plus d'être atteinte de NF1, la patiente avait des myalgies cervicales, des céphalées de tension et un trouble chronique de l'articulation temporomandibulaire. INTERVENTION ET RÉSULTATS: On a opté pour une thérapie manuelle consistant en une décompression discale en flexion-distraction, un relâchement myofascial, l'information sur l'ergonomie du poste de travail et un plan de soins actifs à domicile. Les douleurs et la fréquence des maux de tête de la patiente ont diminué. RÉSUMÉ: La thérapie manuelle sous forme de décompression en flexion-distraction, le relâchement mysofascial et l'information sur les postes de travail ergonomiques ont permis de réduire les douleurs cervicales et thoraciques et la fréquence des maux de tête chez une jeune femme de 21 ans atteinte de NF1.

Progression of Diagnostic Imaging Findings of a Patient With Traumatic Spondylolisthesis Secondary to Unilateral Facet Fractures: A Case Report.

OBJECTIVE: The purpose of this case study is to describe the diagnostic imaging studies of a patient who had a traumatic spondylolisthesis at L5-S1 secondary to unilateral facet fractures. CLINICAL FEATURES: A 21-year-old man experienced a rollover motor vehicle crash that led to low back pain and progressive left-sided radiculopathy. Later, he sought treatment from a doctor of chiropractic because he continued to have low back pain with progressive pain down his left leg. A magnetic resonance imaging study demonstrated a left paracentral disc protrusion at L5-S1. Follow-up computed tomography demonstrated multiple transverse process fractures and left-sided L5-S1 facet fractures with spondylolisthesis that progressed over time. INTERVENTION AND OUTCOME: The patient was referred for a neurosurgical consultation 10 months after the injury. At 12 months after the injury, he underwent transforaminal lumbar interbody fusion with a posterior approach. The patient's pain and radicular symptoms resolved after the surgery. CONCLUSION: This patient exhibited posterior element fractures, had continued symptom progression, and was monitored for the development of a spondylolisthesis. Because of progression and exacerbation of symptoms, neurosurgical consultation for surgical stabilization was mandated.