CLINICAL FEATURES: A 33-year-old male patient presented for follow-up chiropractic care for a long-term low back complaint. A working diagnosis of facet joint syndrome was made. Despite improvement of low back symptoms, the patient experienced right-sided groin pain. The patient was referred to the hospital with a provisional diagnosis of deep vein thrombosis.
INTERVENTIONS AND OUTCOMES: The patient consulted a physician, and within 2 hours of chiropractic consultation, his entire leg had become painful. Doppler ultrasound revealed extensive thrombosis. He was placed on heparin and was hospitalized for 8 days. On discharge, a full-length right leg stocking and moderate exercise were recommended. Consecutive checkups were scheduled with the clot almost resolved at 19 months postdiagnosis.
CONCLUSION: This case report highlights the importance for the manipulative therapist to be aware of cardiovascular disease mechanisms and associated risk factors, so comanagement via referral to the appropriate specialist can occur.
First author: Matthew Fernandez, MChiro
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