Index to Chiropractic Literature
Index to Chiropractic Literature
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ID 20163
  Title Traumatic determinism: Tumours misdiagnosed as sporting injuries. A report of two cases [case report]
Journal Chiropr J Aust. 2008 Jun;38(2):45-48
Peer Review Yes
Publication Type Case Report
Abstract/Notes Objective: To report two cases of patients presenting to chiropractic clinics with previously diagnosed activity-related conditions, in whom bone tumours were found on plain film radiography.

Clinical Features: Case 1 presents a soccer player with a one-year history of left groin pain that had been non-responsive to treatment by a physiotherapist for suspected groin sprain. The physical examination findings reproduced pain over the left superior pubic ramus, but were otherwise unremarkable for the hip. Plain film radiographs demonstrated an expanded sclerotic lesion of the superior pubic ramus. The patient in Case 2 had a previous history of prostate and lung cancer. The 55-year-old presented with right elbow pain that had been previous diagnosed by his oncologist as tennis elbow. Physical examination of the elbow was unremarkable; cervical spine examination revealed restrictions and pain, predominantly within the early range of motion and upon right Kemps manoeuvre. Radiology demonstrated metastatic destruction of the C7 spinous process.

Intervention and Outcome: Both cases were immediately referred to their general practitioner and then for advanced imaging. The diagnosis of the soccer player in Case 1 was fibrous dysplasia rather than a malignant lesion. The patient in Case 2 had surgical removal of bone metastasis, although outcomes were not known upon completion of this paper.

Conclusions: Musculoskeletal tumours may mimic activity-related conditions from both local and referred sites. It is therefore important that a clinician consider imaging or referral to rule out a musculoskeletal tumour. This is particularly emphasised in the case where a suspected.

This abstract is reproduced with the permission of the publisher; full text (print only) by subscription.

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