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Ackowledgments
Introduction

PART I
CHAPTER

xi
Xlll

Musculoskeletal Complaints
1

General Approach to Musculoskeletal
Co...
Appendix 8-1 237
Elbow and Forearm Diagnosis Table 238
CHAPTER

9

Wrist and Forearm Complaints

CHAPTER

241

Context 241...
Relevant Anatomy and Physiology 510
Evaluation 510
Management 512
Appendix 19-1 517
Appendix 19-2 51 7
PART III
CHAPTER

2...
Management 631
Appendix 31-1 633

PART IV
CHAPTER

CHAPTER

Gastrointestinal Complaints

32

Abdominal Pain

637

Context ...
Appendix 42-1 770

PART VII
CHAPTER

43

Relevant Anatomy 825
Evaluation 826
Management 826
Appendix48-1 826

Head and Fac...
Sports-related Issues in the Young Patient 900
A Region-based Approach to Complaints and
Concerns ofPatientlParent 917
App...
Acknowledgments

I would like to express my apprecia tion to those who have
co ntributed to the editing of the firs t two ...
Introduction

What would warrant a third edition? The mere fact that new information is being generated at an exponential ...
of a specific code and/or criteria for commonly seen presentations. These are simply recommended
use guidelines and are no...
WEBSITES

Chiropractic Websites
American Chiropractic Association
http://www.amerchiro.org/
International Chiropractic Ass...
CONTEXT
The approach to a patient's musculoskeletal complaint is
a standardized, often sequential search for what can and
...
III

soft tissue
1. muscle
l!! strain or rupture
trigger points
atrophy
myositic ossificans
muscular dystrophy
rhabdomyosi...
Acromioclavicular separation
Dislocation
Fall onto top of shoulder

S
houlder pointer
Acromioclavicular separation
Distal ...
Blow to anterior knee/patella

Irritation of plica
Patellar fracture
Bursitis
Infrapatellar fat padirritation

V
algusforc...
TABLE

1-2

Synovial Fluid Examination

Cle
ar

N
ormal
Group I
(Noninfiammatory)

DJD
Trauma

Transparent

Yellow

Transp...
HISTORY
A mnemonic approach to the patient's complaints may be
helpful in organizing the vast number of possibilities.
Beg...
while the muscle is lengthening. Although eccentric injury may occur with lifting, this pattern is frequently seen
with ov...
c

LE
'l~3

Selected Arthritic Disorders

s::
~
c::

~

ro
'"

Degenerative

~

Primary Osteoarthritis

~

S'
3

-a

."
~....
TABLE

Selected Arthritic Disorders (continued)

1-~'
'ri!i'

Type

D
iffuse IdiopathicSkeletal
Hyperostosis (DISH) (synon...
~

Selected Arthritic Disorders (continued)

s:
~
c::

~

~

RA (continued)

Asymmetric, bilatera l,polyarticular disorder...
TABLE

1-3

Selected Arthritic Disorders (continued)

Type
Reiter's Syndrome

Features

Age ofonset- 15- 35 ylo
Gender Pre...
~

TABLE

1-3

Selected Arthritic Disorders (continued)

s:
~
c:

~

r.;

Systemic Lupus Erythematosis (SLE)

~

~

b'

3
...
Selected Arthritic Disorders (continued)

Dermatomyositis and Polymyositis
(continued)

Dermatomyositis affects skin and m...
-..
01

,
TA:BlE

'1. -~
s:
S;
c::
"

~
"..
ro

Selected Arthritic Disorders (continued)

Type
OsteitisPubis

~

~

b'
3

...
TABLE

1-3

..

Selected Arthritic Disorders (continued)

Type
HydroxyapatiteDeposition Disease

features
Age of Onset - 4...
...
00

TABLE

1-3

Selected Arthritic Disorders (continued)

~

~

c::

~

~

~

~

Alkaptonuria (Ochronosis)
(continued)...
TABLE

1-3

Selected Arthritic Disorders (continued)

Hyperlipidemia

c-.
ro
:::l
ro

~
:>

""0
""0

a
,..,
'"
=r
.....
o
...
sociated systemic signs may help relate the arthritis to
disorders such as LE, scleroderma, enteropathic arthritides (i.e....
Bone
Tumor-primary or metastatic
Os teoch 0ndros i5/apo physitis
Fracture
Stress fracture
Osteopenia (osteoporosis)
Osteom...
main focus is to determine reproduction of a patient's complaint).
• Nerves-Tapping (i.e., Tinel's) and compression
are di...
No

No

...

6

AROM and PROM
increased; resisted
movement is
painless and strong?

7

Pain on resisted
movement,
especial...
interexaminer reliability using these methods. The interexaminer agreement was 90.5 % with a kappa statistic
ofO.875J
An e...
in the abdominal muscles associated with posterior tightness of the erector spinae (sagittal pattern). A vertical
pattern ...
.. dermopathy suggestive of psoriasis, Reiter's syndrome, melanoma, and the like
.. lymphadenopathy
.. patients unresponsi...
TABLE

1...6

Magnetic Resonance Imaging for the Chiropractor

MRI Equal.to CT
.

·

t

:

MRI of the Head
Severe headache...
Figure 1-2

Passive Care Management-Algorithm

Musculoskeletal
condition meeting
inclusion criteria for
passive care (A)

...
Physiotherapy Approaches for Musculoskeletal Complaints

Pulse Width

Pulse Rate

High Frequency

High75-100

<200

Increa...
EXHIBIT 1-3 (continued)

III

III
III
III
III

III

The tendon or ligament should be placed under slight tension (by stret...
Figure 1-3
Uncomplicated Cases
Acute, recurrent, or
exacerbation of chronic
cases

Acute/Uncomplicated Cases-Algorithm

An...
Figure 1-4

Subacute/Chronic Complicated Cases-Algorithm
Annotation
(A)-Conditions that are exacerbated or recur, refer to...
EXHIBIT 1-4 (continued)

Level 2
• Place the muscle in a stretched position (creating tension).
• Apply muscle-stripping m...
figure 1-5

Active Care Management-Algorithm
Annotations
(A)-Active care criteria: Decreasing pain and inflammation, toler...
Figure 1-6

Active Care: Exercise-Algorithm

Musculoskeletal
condition responsive
to passive and/or
active management

3

...
Thomas Souza D.C. Differential Diagnosis 3rd Edition
Thomas Souza D.C. Differential Diagnosis 3rd Edition
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Thomas Souza D.C. Differential Diagnosis 3rd Edition
Thomas Souza D.C. Differential Diagnosis 3rd Edition
Thomas Souza D.C. Differential Diagnosis 3rd Edition
Thomas Souza D.C. Differential Diagnosis 3rd Edition
Thomas Souza D.C. Differential Diagnosis 3rd Edition
Thomas Souza D.C. Differential Diagnosis 3rd Edition
Thomas Souza D.C. Differential Diagnosis 3rd Edition
Thomas Souza D.C. Differential Diagnosis 3rd Edition
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Thomas Souza D.C. Differential Diagnosis 3rd Edition
Thomas Souza D.C. Differential Diagnosis 3rd Edition
Thomas Souza D.C. Differential Diagnosis 3rd Edition
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Thomas Souza D.C. Differential Diagnosis 3rd Edition
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Thomas Souza D.C. Differential Diagnosis 3rd Edition
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Thomas Souza D.C. Differential Diagnosis 3rd Edition
Thomas Souza D.C. Differential Diagnosis 3rd Edition
Thomas Souza D.C. Differential Diagnosis 3rd Edition
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