ChiroACCESS Article



Diagnostic Imaging Case Report: A 37-year-old female reports with low back pain



This information is provided to you for use in conjunction with your clinical judgment and the specific needs of the patient.

Jack Henry, DC, DACBR

  

Radiology Diagnostics, LLC



Published on

September 8, 2009

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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.

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 37-year-old female reports with low back pain. No history of trauma was reported. Physical exam was equivocal.










FINDINGS

Resolution loss due to the patient’s large size precludes clear visualization of the bony and soft tissue detail. There is no evidence of acute abnormality. Mild degenerative changes are present with in the lumbar spine. A large curvilinear calcific density is projected over the RLQ. This cyst-like density approaches 9 centimeters across its greatest diameter and is relatively well visualized on both frontal and lateral views.

DISCUSSION

The large cyst may be renal in origin. However, other etiology cannot be excluded. Malignancy cannot be ruled in or out with plain film evaluation.

FOLLOW-UP PROTOCOL

A CT and/or US is recommended as an initial follow-up.
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