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Multiple Myeloma

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Pathological Burst Fracture in the Cervical Spine
With Negative Red Flags

By |May 4, 2016|Multiple Myeloma|

Pathological Burst Fracture in the Cervical Spine
With Negative Red Flags: A Case Report

The Chiro.Org Blog


SOURCE:   J Can Chiropr Assoc. 2016 (Mar); 60 (1): 81–87

Jocelyn Cox, DC, Chris DeGraauw, DC FRCCSS(C), and
Erik Klein, DC

Department of Graduate Education and Research Program,
Canadian Memorial Chiropractic College,
6100 Leslie Street,
North York, ON, M2H 3J1


OBJECTIVE:   To report on a case of a pathological burst fracture in the cervical spine where typical core red flag tests failed to identify a significant lesion, and to remind chiropractors to be vigilant in the recognition of subtle signs and symptoms of disease processes.

CLINICAL FEATURES:   A 61-year-old man presented to a chiropractic clinic with neck pain that began earlier that morning. After a physical exam that was relatively unremarkable, imaging identified a burst fracture in the cervical spine.

INTERVENTION & OUTCOMES:   The patient was sent by ambulance to the hospital where he was diagnosed with multiple myeloma. No medical intervention was performed on the fracture.

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Multiple Myeloma Presenting as Sacroiliac Joint Pain: A Case Report

By |August 6, 2012|Diagnosis, Evaluation & Management, Multiple Myeloma|

Multiple Myeloma Presenting as Sacroiliac Joint Pain: A Case Report

The Chiro.Org Blog


SOURCE:   J Can Chiropr Assoc. 2012 (Jun); 56 (2):94-101

Danielle Southerst, BScH, DC, John Dufton, DC, MSc, MD,
Paula Stern, BSc, DC, FCCS(C)

Canadian Memorial Chiropractic College,
Division of Graduate Studies,
6100 Leslie Street,
Toronto, ON, M2H 3J1,
(416) 482-2344 x 287;
dsoutherst@cmcc.ca.


Multiple Myeloma (MM) is the most common primary cancer of bone in adults. The clinical presentation of MM is varied and depends on the sites and extent of involvement. Most importantly for chiropractors, the leading clinical symptoms of MM are related to bone neoplasm and may mimic pain of musculoskeletal origin. The following is the case of a 56 year old male chiropractic patient presenting with a 6 month history of sacroiliac joint pain previously diagnosed and managed unsuccessfully as a hematoma by multiple providers. Physical examination, imaging, and laboratory investigations confirmed a diagnosis of MM. The case report describes relevant pathophysiology, clinical presentation, imaging, and management for MM, while illustrating key issues in patient management as they relate to chiropractic practice and the recognition of pathology in the context of musculoskeletal pain.


From the FULL TEXT Article

Introduction:

Multiple Myeloma (MM) is a primary malignancy of bone marrow characterized by clonal proliferation of plasma cells and production of monoclonal immunoglobulin. It is the most common primary bone cancer in adults [1,2] contributing to 1.3% of new cancer cases in Canada and 1.9% of cancer deaths. [3] In 2008, an estimated 6000 Canadians were living with the disease, including 2100 newly diagnosed. [3] Myeloma is slightly more prevalent in males [4-6] and blacks. [4,5,7] The median age at diagnosis is 66, with the majority diagnosed over the age of 60; [8,9] however in a review of 1027 patients diagnosed with MM, 30% were under the age of 60 and the age of diagnosis ranged from 20–92. [8] The most common symptoms reported are those related to bone neoplasm including unexplained backache that is often severe and precipitated by movement. [8,11] These symptoms may motivate a patient to seek conservative care for what is assumed to be a complaint of musculoskeletal origin. This case emphasizes key components of patient management as they relate to chiropractic practice and the recognition of pathology in the context of a patient presenting with pain of presumed musculoskeletal origin.


Discussion:

Pathophysiology (more…)