By: Terry R. Yochum, DC, DACBR, Fellow, ACCR and Michael S. Barry, DC, DACBR History What is this unusual lesion of the ischium? Does this patient need to be referred Figure 1 Diagnosis: Rider’s bone (avulsion of the secondary growth center for the ischial tuberosity). Discussion This type of fracture represents an avulsion of the
By: Terry R. Yochum, DC, DACBR, Fellow, ACCR and Michael S. Barry, DC, DACBR History A 10-year-old male gymnast presents with post-traumatic ankle pain following a fall from the platform bar. Radiographic examination reveals: Figure 1. Diagnosis: Nonossifying fibroma (fibrous xanthoma) of the distal tibial metaphysis with a spiral pathological fracture. Fibrous Xanthoma of Bone—Nonossifying
By: Terry Yochum, DC, DACBR, Fellow, ACCR and Michael S. Barry, DC, DACBR History This young adult male patient was in a motor vehicle accident, where he received a severe hyperextension-hyperflexion injury. A complete set of conventional radiographs was performed and an abnormality was detected on the lateral projection. Can you identify the pathology? Figure
By: Terry R. Yochum, DC, DACBR, Fellow, ACCR and Michael S. Barry, DC, DACBR History A 50-year-old male patient presents with pain affecting his first metatarsal and interphalangeal articulation of the great toe. What is your diagnosis? Figure 1. Diagnosis: Gout. Observe the tophaceous marginal erosions on the lateral aspect of the distal phalanx of
By: Terry R. Yochum, DC, DACBR, Fellow, ACCR and Michael S. Barry., DC, DACBR A Potentially Life-Threatening Circumstance History This 75-year-old female patient tripped going down her basement stairs and heard a “snap.” This resulted in osseous injury. Can you tell the location and the extent of the injury? Figure 1 Diagnosis: There is
By Terry R. Yochum, DC, DACBR, Fellow, ACCR and Michael S. Barry, DC, DACBR History This 35-year-old female patient presents with a history of severe “whiplash” and cervicodorsal pain. An abnormality of T2 is identified. Is this a fracture? Is additional imaging necessary to confirm this? Figure 1 Diagnosis: The abnormality at the T2 vertebral segments
By: Terry R. Yochum, DC, DACBR, Fellow, ACCR and Michael S. Barry, DC, DACBR History This young female patient presents with a history of trauma to the cervicothoracic junction. What is your diagnosis? Figure 1 Diagnosis: Bilateral cervical ribs. Note that the ribs extending from the C-7 transverse processes project caudally. The transverse processes of
By: Terry R. Yochum, DC, DACBR, Fellow, ACCR and Michael S. Barry, DC, DACBR History This eight-year-old patient presents with a history of scoliosis and back pain. Where and what are the peculiar calcifications? Are these symptom-producing lesions? (See next page.) Diagnosis Childhood idiopathic intervertebral disc calcification. Discussion There are two forms of disc calcification, apparently
By: Terry R. Yochum, DC, DACBR, Fellow, ACCR and Michael S. Barry, DC, DACBR History This adult male patient reports with a history of trauma to the upper lumbar spine and lumbosacral junction after a severe fall. Can you find any fractures? If so, where are they? (See next page.) Diagnosis Fractures of the left first,
By: Terry R. Yochum, DC, DACBR, Fellow, ACCR and Michael S. Barry, DC, DACBR History Two adult patients present with a long-standing history of shoulder pain. The diagnosis in Figures 1 and 2 is the same. What’s your diagnosis? Diagnosis Degenerative joint disease (osteoarthritis) of the glenohumeral articulation. In Fig. 2, there is an associated
By: Terry R. Yochum, DC, DACBR, Fellow, ACCR and Michael S. Barry, DC, DACBR History This adult female patient fell on a hyperextended elbow and wrist while jogging. There is considerable restriction in range of motion of the elbow with localized elbow pain. What do you see? Diagnosis There is a vertical fracture line extending through
By: Terry R. Yochum, DC, DACBR, Fellow, ACCR, Michael S. Barry, DC, DACBR, and Chad J. Maola, DC History While playing football, this young adult male patient suffered shoulder trauma and complains of pain. Is there any abnormality on these images? Diagnosis Traumatic dislocation of the acromioclavicular joint, Type III. Acromioclavicular Joint Separations The traumatic
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: 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: 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: 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: 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: Robert Kuhn, D.C., D.A.C.B.R., Terry R. Yochum, D.C., D.A.C.B.R., Anton R. Cherry, D.C., Sean S. Rodgers, D.C., and Dennis Nosco, Ph.D. The Effect of an Orthotic Device on the Quadriceps Femoris Angle Download PDF
By: Robert Kuhn, D.C., Nofa J. Shibley, D.C., William M. Austin, D.C., and Terry R. Yochum, D.C. Radiographic Evaluation of Weightbeardsing Orthotics and Their Effect on Flexible Pes Plantus Download PDF
