Hello. My name is Jack Henry, DC, DACBR. I am Radiologist-in-Chief of
Radiology Diagnostics, LLC, an industry leader of Chiropractic Radiology Services and Digitized Spinographic analyses. All of our services are provided at no cost to doctor and no/low cost to patients.
Selected cases will be presented for your evaluation. The studies may or may not have abnormalities. Use the arrow keys or the scroll bar to carefully evaluate the films.
Step 1: Is the study abnormal or normal?
Step 2: If the study is abnormal, what is your best diagnosis?
Step 3: Which follow-up imaging option would be best?
Step 4: Compare your results with the correct diagnosis.
HISTORY
A 71-year-old male reports chronic low back and hip pain. No history of recent trauma was reported. Physical exam findings were not provided at the time of formal image interpretation.
FINDINGS
The study is negative for acute fracture or dislocation. Moderate to marked DDD and DJD noted throughout the lumbar spine. A Schmorl’s node is present at the L1 disc level. Hip arthrosis is seen bilaterally more so on the left. The left femoral capitis and neck appears somewhat broad based and foreshortened secondary to previous injury. More importantly, note the large generalized AAA measuring approximately 5.1 cm at the L3 disc level.
DISCUSSION
Remember, not all back pain is mechanical in nature. Chiropractors must always be cognizant of other considerations.
FOLLOW UP PROTOCOL
A CT evaluation is recommended as an initial follow up.