CASE OF THE WEEK 84 Courtesy of Michelle Wessely DC, DACBR and Tim Mick, DC, DACBR Minnesota, USA A...
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CASE OF THE WEEK 84 CASE OF THE WEEK 84 Courtesy of Michelle Wessely DC, Courtesy of Michelle Wessely DC, DACBR and Tim Mick, DC, DACBR DACBR and Tim Mick, DC, DACBR Minnesota, USA Minnesota, USA A 52-year-old male with a sit down type A 52-year-old male with a sit down type fall recently, resulting in severe back fall recently, resulting in severe back pain, centered around L1. There is pain, centered around L1. There is also a history of “long-standing” prior also a history of “long-standing” prior trauma related to a motorcycle trauma related to a motorcycle accident, with no focal upper lumbar accident, with no focal upper lumbar pain at that time. pain at that time.
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Transcript of CASE OF THE WEEK 84 Courtesy of Michelle Wessely DC, DACBR and Tim Mick, DC, DACBR Minnesota, USA A...
CASE OF THE WEEK 84CASE OF THE WEEK 84
Courtesy of Michelle Wessely DC, DACBR and Courtesy of Michelle Wessely DC, DACBR and Tim Mick, DC, DACBRTim Mick, DC, DACBR
Minnesota, USAMinnesota, USA
A 52-year-old male with a sit down type fall recently, A 52-year-old male with a sit down type fall recently, resulting in severe back pain, centered around L1. resulting in severe back pain, centered around L1.
There is also a history of “long-standing” prior There is also a history of “long-standing” prior trauma related to a motorcycle accident, with no trauma related to a motorcycle accident, with no
focal upper lumbar pain at that time.focal upper lumbar pain at that time.
What are the abnormal findings? What is/are the What are the abnormal findings? What is/are the diagnoses? What is the clinical significance?diagnoses? What is the clinical significance?
AnswersAnswers Abnormal findings:Abnormal findings:
Multiple focal round soft tissue Multiple focal round soft tissue densities.densities.Loss of anterior and posterior Loss of anterior and posterior body height of L1 with retropulsion body height of L1 with retropulsion in to central canal.in to central canal.
Diagnosis:Diagnosis:Neurofibromatosis (NFT)Neurofibromatosis (NFT)Recent burst-type fracture of L1Recent burst-type fracture of L1
Clinical Significance:Clinical Significance:NFM patients have reduced bone NFM patients have reduced bone density, as well as multisystem density, as well as multisystem abnormalities such as vascular, abnormalities such as vascular, optic, osseous and cutaneous optic, osseous and cutaneous lesions.lesions.Recent burst-type fracture of L1 Recent burst-type fracture of L1 may be associated with neural may be associated with neural compromise and MR imaging is compromise and MR imaging is indicated to evaluate.indicated to evaluate.
Additional information on this Additional information on this patientpatient
He was aware of his NFT before He was aware of his NFT before presenting to the chiropractor in presenting to the chiropractor in Minnesota.Minnesota.
His left lower limb had been amputated His left lower limb had been amputated (did you catch this on the AP lumbopelvic (did you catch this on the AP lumbopelvic radiograph?)! This is likely to a history of radiograph?)! This is likely to a history of focal gigantism, whereby a region, usually focal gigantism, whereby a region, usually a finger or toe is hypertrophied.a finger or toe is hypertrophied.
