Term
| Chronic inflammatory condition involving the sacroiliac joints and the axial skeleton marked by bone formation at ligament and tendon attachments |
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Definition
| ANKYLOSING SPONDYLITIS [Marie-Strumpell’s disease] |
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Term
| Genetic predisposition with HLA-B27 antigen being present in >90% of patients, 3-4 times more common in males, Peak age between 25-35 years |
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Definition
| ANKYLOSING SPONDYLITIS [Marie-Strumpell’s disease] |
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Term
| Modified New York criteria: low backache > 3 months duration, better with exercise not with rest, limitation of lumbar spine movement in sagittal and coronal planes, bilateral sacroiliac tenderness, decreased chest expansion with inspiration, |
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Definition
| ANKYLOSING SPONDYLITIS [Marie-Strumpell’s disease] |
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Term
| Patrick’s test will be positive if there is pain in the sacroiliac joint when pressure is placed on the ASIS and knee |
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Definition
| ANKYLOSING SPONDYLITIS [Marie-Strumpell’s disease] |
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Term
| SI joint x-rays-moderate to severe sacroilitis [subchondral bony erosions on the iliac side of the SI joint initially followed by Romanus lesions [erosions of the corners of the vertebral bodies], then shiny corners, marginal syndesmophytes, dagger sign and finally the bamboo spine years later |
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Definition
| ANKYLOSING SPONDYLITIS [Marie-Strumpell’s disease] |
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Term
| Elevated ESR and C-Reactive Protein will be seen along with a +HLA-B27 |
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Definition
| ANKYLOSING SPONDYLITIS [Marie-Strumpell’s disease] |
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Term
| Alkaline phosphatase may be raised when there is active bone remodeling |
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Definition
| ANKYLOSING SPONDYLITIS [Marie-Strumpell’s disease] |
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Term
| Co-manage with a rheumatologist |
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Definition
| ANKYLOSING SPONDYLITIS [Marie-Strumpell’s disease] |
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Term
| Fracture of the vertebral body, usually following trauma |
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Definition
| COMPRESSION VERTEBRAL FRACTURE |
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Term
| In older patients it can be caused by osteoporosis or malignancy and may follow a minor event such as stepping off a step or sneezing |
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Definition
| COMPRESSION VERTEBRAL FRACTURE |
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Term
| In young patients, it is usually caused by trauma, especially a hyperflexion injury. Other causes may include long-term corticosteroid use and hyperthyroidism. |
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Definition
| COMPRESSION VERTEBRAL FRACTURE |
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Term
| More common in the midthoracic region but may affect the lumbar spine |
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Definition
| COMPRESSION VERTEBRAL FRACTURE |
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Term
| Sudden back pain and increased kyphosis. Pain on percussion |
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Definition
| COMPRESSION VERTEBRAL FRACTURE |
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Term
| X-ray is diagnostic and may show a step defect. If the posterior elements of the vertebra [vertebra plana] are compressed, suspect malignancy or other pathology |
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Definition
| COMPRESSION VERTEBRAL FRACTURE |
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Term
| There must be a minimum of three vertebra involved. |
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Definition
| COMPRESSION VERTEBRAL FRACTURE |
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Term
| Co-manage with an orthopedist. Avoid flexion exercises. Healing should be within 3 months. |
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Definition
| COMPRESSION VERTEBRAL FRACTURE |
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Term
| Aberrant growth of endometrium outside of the uterine cavity, Unknown; theories include retrograde menstruation, metaplastic transformation or vascular dissemination, There may be a genetic link |
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Definition
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Term
| Results in endometrial deposits in the dependent parts of the pelvis and on the ovaries |
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Definition
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Term
| Seen in 10% of all menstruating women and 4 times more common in infertile women |
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Definition
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Term
| Severe dysmenorrhea [5-7 days before the start of the period] with dyspareunia [painful sex especially with deep penetration] and backache which is worse during menstruation; may present with infertility |
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Definition
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Term
| There may be tender nodules in the posterior vaginal fornix and the uterus may be fixed or retroverted |
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Definition
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Term
| Ultrasound is the preferred initial investigation as it would show cystic lesions in the pelvis; diagnosis to be confirmed by laparoscopic biopsy of the cysts |
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Definition
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Term
| Refer to a gynecologist for further investigation and treatment if chiropractic care is not helpful |
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Definition
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Term
| Pain related to the zygapophaseal joint between adjacent vertebrae |
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Definition
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Term
| Degenerative joint disease or trapped meniscoid tissue between the articular facets |
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Definition
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Term
| Unilateral back pain that is better on lying down and worse on rotating the spine |
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Definition
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Term
| Kemp’s test will be positive [pain on lateral bending followed by extension] |
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Definition
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Term
| X-rays may reveal evidence of degenerative joint disease: joint space narrowing subchondral sclerosis osteophytes |
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Definition
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Term
| Chiropractic adjustments are superior to medical treatment |
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Definition
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Term
| Postural changes associated with hypolordosis of the lumbar spine |
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Definition
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Term
| May develop in a person who sits for prolonged periods |
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Definition
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Term
| The patient presents with low back pain and possible knee pain |
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Definition
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Term
| Examination reveals an anterior pelvic tilt, a sway back and tightness and shortening of the following muscles: Iliopsoas rectus abdominis tensor fascia latae erector spinae muscles along with weakness and inhibition in the following muscles: gluteal muscles other abdominal muscles-external oblique, internal oblique and transversus abdominis |
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Definition
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Term
| Muscle strengthening for the weak muscles and stretching of the tight muscles |
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Definition
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Term
| Prolapse of the nucleus pulposus of an affected lumbar intervertebral disc with compression or irritation of lumbar spinal roots |
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Definition
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Term
| Degenerative Joint Disease |
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Definition
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Term
| Low back pain radiating into the back of the thigh and leg |
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Definition
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Term
| There might be paresthesia along the affected dermatome and decreased or absent deep tendon reflexes [quadriceps-L4] or hamstring [L5] or ankle [S1] |
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Definition
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Term
| Straight Leg Raising [elevation of the extended knee] test-pain present between 350 to 700 indicates nerve root tension or irritation due to a disc bulge |
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Definition
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Term
| Braggard’s [dorsiflexion of ankle with SLR] test might be reproduce pain between 300 to 650-nerve root tension or irritation |
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Definition
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Term
| Lumbar x-rays may show narrowing of joint space and osteophytes |
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Definition
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Term
| MRI will show the posterolateral disc bulge |
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Definition
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Term
| Chiropractic treatment unless there is evidence of cauda equina syndrome: Urinary retention Decreased anal sphincter tone Saddle anesthesia |
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Definition
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Term
| If evidence of cauda equina syndrome is present, refer at once to the hospital |
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Definition
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Term
| Inflammation of the meninges with increased intracranial pressure. |
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Definition
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Term
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Definition
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Term
| Fever, headache, neck stiffness, photophobia, muscle pain, malaise, nausea, vomiting and change in the mental status |
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Definition
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Term
| Kernig’s [neck pain on leg extension] test will be positive |
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Definition
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Term
| Brudzinski’s sign [knees bend and “buckle” on neck flexion] may also be positive |
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Definition
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Term
| CSF may show increased WBCs: neutrophils in bacterial infection, lymphocytes in viral and fungal infections; CSF glucose is decreased in bacterial and fungal infections; CSF protein is increased in bacterial infections |
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Definition
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Term
| Refer to the hospital urgently |
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Definition
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Term
| Progressive neoplastic plasma cell disease characterized by excessive immunoglobulin production |
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Definition
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Term
| Peak incidence between 50-70 years |
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Definition
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Term
| Most common primary bone tumor; twice as common in blacks |
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Definition
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Term
| Fatigue, nocturnal backache, recurrent infections, constipation, blurred vision, constipation, nerve root compression and mental changes |
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Definition
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Term
| Tenderness on percussion of spinous process might be positive |
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Definition
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Term
| Comprehensive Metabolic Profile will reveal hypercalcemia, elevated serum proteins, reversed Albumin/Globulin ratio [1:2 instead of 2:1] |
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Definition
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Term
| Bence Jones proteins [IgG] may be found in the urine |
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Definition
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Term
| Serum electrophoresis will show a typical M [myeloma] spike due to high IgG |
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Definition
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Term
| X-rays in 70% of patients might show multiple lytic bone lesions [punched out or rain-drop lesions] mainly in the skull, long bones and vertebrae; osteoporosis and blastic lesions may also be present |
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Definition
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Term
| Bone marrow biopsy will confirm the diagnosis: malignant plasma cells |
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Definition
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Term
| Refer to a hematologist for further investigation and management |
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Definition
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Term
| Midback pain caused by poor posture |
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Definition
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Term
| Poor posture and working at a desk. The anterior muscles become tight and the posterior muscles become stretched and weak. |
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Definition
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Term
| Patient complains of constant and chronic aching mid-back pain. Pain may be worse with working at a desk and better with activity. Patient may present with a forward head carriage. |
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Definition
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Term
| Examination may reveal trigger points in the upper and middle traps, rhomboids, levator scapulae and pectorals. The lower trapezius will be weak. |
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Definition
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Term
| Chiropractic adjustments along with deep massage, postural advice and exercises are usually very helpful. Stretch tight muscles and strengthen the weak ones. Address work ergonomics. |
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Definition
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Term
| Infection of the parenchyma of the kidney and the renal pelvis |
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Definition
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Term
| Escherichia coli is the commonest causative agent; often associated with ascending infection from a bladder infection; seen more often in women and in patients with diabetes mellitus; also seen in vesicoureteric reflex |
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Definition
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Term
| The classic presentation includes: chills fever acute flank pain nausea vomiting CVA tenderness often with dysuria, urgency and frequency of urination |
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Definition
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Term
| Murphy’s punch [percussion of the costovertebral angle] may be positive |
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Definition
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Term
| Urinalysis will reveal white blood cell casts, bacteruria, pyuria and hematuria; urine culture will show a heavy growth of the offending bacteria-E. coli [lactose fermenting] or Proteus mirabilis [maltose fermenting] |
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Definition
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Term
| Refer to the hospital for treatment |
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Definition
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Term
| Renal cell carcinoma originating from cells of the proximal tubules of the kidney |
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Definition
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Term
| Cigarette smoking and a positive family history; male: female ratio of 2:1 |
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Definition
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Term
| Painless hematuria with flank mass in some patients; there may be fever or weight loss; there may be pain in some patients |
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Definition
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Term
| Urinalysis may show numerous red blood cells; cytology of the urine may reveal malignant transitional cells; CT scan will reveal a mass in the kidney |
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Definition
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Term
| Refer to a nephrologist for further investigation and treatment |
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Definition
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Term
| Severe pain due to a stone in the renal pelvis or ureter |
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Definition
| RENAL COLIC [Kidney Stones] |
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Term
| Diet, decreased fluid intake, areas of high humidity and elevated temperatures |
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Definition
| RENAL COLIC [Kidney Stones] |
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Term
| Sudden onset of severe flank pain, which may radiate into the groin as the stone descends in the ureter; there may nausea and vomiting |
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Definition
| RENAL COLIC [Kidney Stones] |
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Term
| The patient is often restless, constantly moving in contrast to a patient with acute abdominal pain who remain still |
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Definition
| RENAL COLIC [Kidney Stones] |
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Term
| Plain x-ray of the abdomen will reveal most stones [85%] |
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Definition
| RENAL COLIC [Kidney Stones] |
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Term
| Spiral CT scan has emerged as a first-line tool for evaluating flank pain |
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Definition
| RENAL COLIC [Kidney Stones] |
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Term
| Urinalysis usually reveals numerous red blood cells and crystals; urinary pH below 5.5 is suggestive of uric acid or cystine stones; pH above 7.2 is more suggestive of struvite stones |
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Definition
| RENAL COLIC [Kidney Stones] |
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Term
| Refer to the hospital for further treatment |
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Definition
| RENAL COLIC [Kidney Stones] |
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Term
| Advise the patient to drink lots of water frequently to avoid recurrence |
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Definition
| RENAL COLIC [Kidney Stones] |
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Term
| Spine disease affecting the adolescent |
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Definition
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Term
| may be a result from trauma to the vertebral growth plate. More common in males, 13-17 years of age; more common in the midthoracic region |
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Definition
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Term
| The classic triad includes Schmorl’s nodes, limbus bones and irregular endplates; affect three or more vertebrae |
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Definition
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Term
| May be asymptomatic or may present with back pain and increased kyphosis |
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Definition
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Term
| There must be a minimum of three vertebra involved. |
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Definition
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Term
| Co-manage with an orthopedist. |
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Definition
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Term
| Movement of a vertebral body in relation to the vertebral body below |
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Definition
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Term
| Acquired related to stress fractures; the degenerative type is more common in females, over 40 years and frequently affects the fourth lumbar vertebra |
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Definition
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Term
| Often asymptomatic; may present with low backache and a step sign on palpation if it is severe; no change in the muscle power, sensation or reflexes |
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Definition
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Term
| Lateral lumbar x-rays will show the anterior slippage of L5 on S1 [most common] or L4 on L5 [second most common] |
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Definition
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Term
| Use the Meyerding Grading method to quantify degree of slippage by dividing the A/P width of the base of the sacrum into fourths |
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Definition
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Term
| An inverted Napoleon hat sign may be present on the AP view if severe |
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Definition
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Term
| Chiropractic management directed on the segment below the segment may improve the biomechanics; avoid adjustments in progressive unstable types |
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Definition
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Term
| Refer to an orthopedic surgeon if it is a Grade 3 or 4 slippage |
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Definition
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