Journal of manipulative and physiological therapeutics
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J Manipulative Physiol Ther · Jul 1999
Case ReportsExtraspinal enthesopathy caused by isotretinoin therapy.
To discuss a case of diffuse peripheral enthesopathy in a patient previously treated with long-term isotretinoin (Accutane) for severe acne. ⋯ Accutane-induced enthesopathy should be considered in individuals with correlating radiologic and clinical features and history of retinoic acid therapy for acne. This should be a diagnosis by exclusion, after eliminating other potential causes of peripheral enthesopathy, particularly diffuse idiopathic skeletal hyperostosis, seronegative spondylarthropathy, and fluorosis.
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J Manipulative Physiol Ther · Jul 1999
Randomized Controlled Trial Comparative Study Clinical TrialChronic spinal pain syndromes: a clinical pilot trial comparing acupuncture, a nonsteroidal anti-inflammatory drug, and spinal manipulation.
To compare needle acupuncture, medication (tenoxicam with ranitidine), and spinal manipulation for managing chronic (>13 weeks duration) spinal pain syndromes. ⋯ The consistency of the results provides, in spite of several discussed shortcomings of this pilot study, evidence that in patients with chronic spinal pain syndromes spinal manipulation, if not contraindicated, results in greater improvement than acupuncture and medicine.
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J Manipulative Physiol Ther · May 1999
Review Case ReportsManagement of acute lumbar disk herniation initially presenting as mechanical low back pain.
To describe the clinical management with spinal manipulation of a male patient with risk factors for lumbar disk herniation initially suffering from what appeared to be mechanical low back pain that evolved into radiculopathy; also to review issues pertinent to chiropractic/manipulative management of disk herniation. ⋯ Risk factors for the development of disk herniation should be considered when assessing patients suffering from what appears to be mechanical low back pain. The role played by manipulation in the development of disk herniation in this case was believed to be circumstantial rather than causal. Manipulation was used in the treatment of this patient over a period of approximately 2 months; after this time, clinical and partial computed tomography imaging resolution was evident. Ongoing clinical (neurologic) evaluation of patients with manifest or suspected disk herniation is an important aspect of management. Good-quality trials of manipulation for patients with disk herniation are imperative for the chiropractic profession.
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In the literature of manual medicine the sacroiliac joint is widely accepted as a potential source of low back pain. On the other hand, some investigations have detected sacroiliac joint dysfunction without concomitant low back pain. The prevalence of sacroiliac dysfunction in the population has been noted in the medical literature to be between 19.3% and 47.9%. However, the prevalence of sacroiliac dysfunction in the general population and for construction workers is unknown. ⋯ The reason why symptomatic and asymptomatic sacroiliac dysfunctions exist has not yet been sufficiently explained. The identification of pain-provoking factors should be the aim of subsequent investigations. A further study with a prospective design will be necessary to answer the questions that remain.
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J Manipulative Physiol Ther · Feb 1999
Randomized Controlled Trial Clinical TrialChanges and implications of blood flow velocity of the vertebral artery during rotation and extension of the head.
To study the effects of extension and extension-rotation of the head on the blood flow velocity of the vertebral artery experimentally and clinically. ⋯ Extreme rotation and extension are dangerous to patients who have abnormal vertebral arteries when extreme rotatory and extension manipulations are applied. Doctors should be very careful when rotating the patient's head to the right side.