Differential Diagnosis and Management for the Chiropractor: by Thomas Souza

By Thomas Souza

The 3rd variation of this most sensible promoting reference continues its aim of aiding the practitioner evaluation a patient's criticism within the context of a chiropractor's scope of practice.

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Additional info for Differential Diagnosis and Management for the Chiropractor: Protocols and Algorithms (3rd Edition)

Sample text

In general: III III III III III Radiography-Signs of many conditions, including cancer, fracture, infection, osteoporosis, and degeneration, often are visible. The degree of sensitivity is quite low with early disease, however. Magnetic resonance imaging (MRI) is extremely valuable in evaluating soft tissue such as tendons, ligaments, and discs. In evaluating the volume of tumor or infection involvement, MRI is also valuable. Spinal cord processes such as multiple sclerosis or syringomyelia are well visualized on MRI (Table 1-6).

When specific sites in the extremities are exposed through specific positioning, however, the reliability may increase. 3 Although orthopaedic testing is the standard for orthopaedists , more involved investigations are usually added by the chiropractor and/or manual therapist. The first is based on the work of Cyriax,4 which emphasizes the "feel" of soft tissue palpation, especially at end-range. Combined with this end-range determination, a selective tension approach is incorporated using the responses to active, active resisted, and passive movements to differentiate between contractile (muscle/tendon) and noncontractile (ligament/capsule and bursa) tissue.

Strength A slow full-range movement is performed and heJd for an isometric contraction of up to 30 seconds at end-range. This is followed by a slow eccentric phase (at least twice as long as the concentric). Rest for 10 seconds and perform again for up to 10 repetitions (pain or fatigue dependent). When performed for 2 or 3 days pain free, move to next phase. Endurance A fast full-range movement is performed at the rate of one per second. Tbis may be performed for 50 to 60 seconds or until pain or fatigue is felt.

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