ChiroACCESS Article



Diagnostic Imaging Case Report: A 67-year-old male reports with chronic 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

June 16, 2011

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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.  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 67-year-old male reports with chronic back pain. The patient’s past medical history was not provided at the time of formal reading.







FINDINGS

The study is negative for acute fracture or dislocation. The L6 segment is partially transitional. Moderate degenerative changes are present within the lumbar spine with a slight degenerative anterolisthesis L6 on S1 of five percent. Calcification of the abdominal aorta is noted. Please note the suspicious focal densities projected over the L5, L4, and L3 vertebrae best seen on the lateral view.


DISCUSSION

The densities appear to be related to the unspecified pelvic basin surgical procedure. These focal densities should be considered blastic METS primary prostate.


FOLLOW UP PROTOCOL

Clinical correlation with lumbar pelvic MRI is recommended as an initial follow-up. This case was relatively easy. What was troubling is why the attending withheld important clinical and historical information. It is crucial that the attending provides as much clinical information to the specialist to afford the most accurate diagnosis.

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