By: Terrence J. Dini, DC Introduction Pes anserine bursitis is the result of inflammation of the same bursal sac at the medial aspect of the knee. It is a fairly common finding, but often overlooked and not very prevalent in the literature. There are many causes of this type of bursitis, but pronation of the
By: Terry R. Yochum, DC, DACBR, Fellow, ACCR, Michael S. Barry, DC, DACBR, and Chad J. Maola, DC History This adult male patient complains of chronic pain in the finger with an enlarging mass. What is your diagnosis? Diagnosis Malignant degeneration of a previously benign solitary enchondroma. General Considerations Solitary enchondroma is a common benign
By: Wayne Henry Zemelka, DC Analysis A ‘High Shoulder’ is easily detected by comparing one shoulder with the other, especially in the standing position (Fig. 1). Keep in mind that previous injury or broken bones may be considered contraindications when conducting your examination. With palpation you will find a tender nodule or trigger point at
By: Terry R. Yochum, DC, DACBR, Fellow, ACCR, Michael S. Barry, DC, DACBR, and Chad J. Maola, DC The Ischial Tuberosity: Normal Variant or Pathology? History This young female presents with pain in the area of the ischial tuberosity following running hurdles for her track team. There is an unusual appearance of the ischial tuberosity.
By: Wayne Henry Zemelka, DC Analysis With the patient in a sitting position palpate along the vertebrae. You will find the rib head very tender without posteriority or laterality of the vertebra. The involved rib head and rib are inferior in relationship to the rib heads above and below. Additionally you will feel the inferior
By: Terry R. Yochum, DC, DACBR, Fellow, ACCR, Michael S. Barry, DC, DACBR, and Chad J. Maola, DC History This young adult male fell on an outstretched hand, locking his elbow while jogging. He immediately experienced pain on the lateral side of the elbow. Can you find the abnormality? Diagnosis Observe the radiolucent fracture of
By: Tim Maggs, DC Many Chiropractors would love to become more involved with both industry and sports teams in their area. These same Chiropractors know they could provide tremendous benefits if given the opportunity. The problem arises when they attempt to become involved, as politics and mis-education usually barricades the entry. The Medical Model Chiropractors
By: Wayne Henry Zemelka, DC Keeping the record straight: The anterior thoracic is the loss of curvature in the dorsal region which gives the appearance that the vertebrae have moved anterior-ward, which in turn gives the appearance of flattening of the kyphotic curvature of the Dorsal vertebrae (Fig. 1). Therefore the name, ‘Anterior Thoracic.’ Analysis
By: Terry R. Yochum, DC, DACBR, Fellow, ACCR and Chad J. Maola, DC Case History This 10-year-old male soccer player complaining of knee pain and shin splints was taken to his family medical doctor by his mother. She was told he needed no X-rays (since there had been no trauma) and was diagnosed with “growing
By: William M. Austin, DC, CCSP, CCRD During standing, walking, and running the lumbar spine and pelvis balance on the lower extremities. As shown in Fig. 1, leg or foot asymmetries send abnormal forces along the closed Kinetic/Kinematic Chain, interfering with spinal function.1 And interfering with spinal function can result in a number of bodily malfunctions.
By: Terry R. Yochum, DC, DACBR, Fellow, ACCR and Chad J. Maola, DC DISCUSSION Degenerative spondylolisthesis is a type of non-spondylolytic spondylolisthesis (no pars defects). Degenerative spondylolisthesis can affect any degenerated vertebral segment positioned within a lordotic curve. In the lumbar spine, it most commonly affects L4 (Figs. 2 & 3), with approximately 10 times
By: Terry R. Yochum, DC, DACBR, Fellow, ACCR, and Chad J. Maola, DC Case History This young adult presents with pain in the hip after suffering trauma. Is there a fracture? DIAGNOSIS Monostotic Fibrous Dysplasia. Observe the geographic radiolucency just below the lesser trochanter. There is a “ground glass” matrix and a sclerotic border.
By: Wayne Henry Zemelka, DC Needless to say, the pelvis is one of the main areas that we need to be cognizant about. Throughout you will find references made by Drs. Barge, Gonstead, Logan, and others concerning the proper alignment of the pelvic girdle to restore or hold the integrity of the spinal column (Fig.
By: Terry R. Yochum, DC, DACBR, Fellow, ACCR, and Chad J. Maola, DC CASE HISTORY A young male patient injures his hand in a traumatic event. Do you see the fracture? (See next page for Diagnosis.) DIAGNOSIS Barroom fracture of the 5th metacarpal with palmer displacement of the 5th metacarpal head. GENERAL CONSIDERATIONS The phalanges
By: Terry R. Yochum, DC, DACBR, Fellow, ACCR, and Chad J. Maola, DC Case History This young adult male patient falls on a hyperextended elbow and has immediate pain on the lateral aspect of the elbow. X-rays were taken at the emergency room to rule out fracture. What do you see? Diagnosis There is an
By: Terry R. Yochum, DC, DACBR, Fellow, ACCR, and Chad J. Maola, DC Case History These two young athletes had a severe inversion strain of their ankles playing soccer and could barely bear weight. (Figures 1 & 2) Note the oblique radiolucent fracture line through the distal fibula of both patients. Discussion The routine radiographic
By: Terry R. Yochum, DC, DACBR, Fellow, ACCR, and Chad J. Maola, DC Case History This adult male patient presents with pain in the wrist. Observe the widened scapholunate space. What may this be indicative of? Diagnosis The widening of the scapholunate space is characteristic of scapholunate disassociation creating the classic “Terry Thomas Sign.” This
By: Wayne Henry Zemelka, DC The Thompson Technique: Is a low force, hands-on adjusting technique Transfers less reflective force into the joints of the doctor’s arms and shoulders Is a great way to adjust children and adults Is one of the top Chiropractic adjusting techniques in the world Is a Chiropractic adjusting technique that follows
By: Tim Maggs, DC In athletes, shin splints and stress fractures are typically a result of repetitive motion injury in one or more supportive muscles in the lower leg. Very often these muscles work without ever fully recovering before being asked to perform again. All athletes use similar muscles as they participate in sport specific
By: Terry R. Yochum, DC, DACBR, Fellow, ACCR, and Chad J. Maola, DC Case History This 50-year-old female patient presents with localized lumbosacral pain of six months’ duration. Radiographs of the lumbar spine reveal a striking abnormality. What is it? Diagnosis Note the extensive reactive sclerosis affecting the facet structures bilaterally at the L5/S1 level.