Academy of Chiropractic Personal Injury & Primary Spine Care Program

Quickie Consult 836
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From the Desk of Dr. Mark Studin
Academy of Chiropractic
Preamble: many of these issues are small, yet each issue is just that… an issue. If you take care of the small issues, then the larger issues often take care of themselves and you can focus on the larger issues… a larger, more profitable practice and more family time.

“Case History and a Case for X-Raying”

If I can’t see it, I guess I have to guess… Mark Studin 2017



This happened yesterday and I am taking some liberties because I can’t remember all the facts because I am getting OLD and Senile!!!! 

 
Patient: 74 year old female

Primary Complaint: Low back pain

Clinical Findings: some of this and some of that, but basically neurologically intact (Salvaggione… just shut up because I don’t want to hear that is not good enough! And Matt E… please don’t call with a 2-hour dissertation of why that is insufficient… oy!!!  Please see the Salvaggione comment)

 
Past History: Spinal Stenosis
An unremarkeable MRI taken 1-year prior based upon the radiologist’s report

 
After the 1st adjustment, the patient complained of increased hip and low back pain. After the second adjusment, the pain got worse. After the 3rd adjustment, the pain was relentless with ambulation not possible secondary to the pain.
 

Now… the patient wants a full refund for all the money paid and is screaming (not threatening law suits yet).
 

What was done wrong? First, NEVER trust a radiologist’s report. READ YOUR OWN images and get trained because most general radiologist’s report are not accurate. Take x-rays to determine if there is demineralization of any kind. Was there a compression fracture?  Or… is there one now because the patient was osteoporitic?

 
Is there a new herniation? Has the stenosis severely increased leaving no “real-estate” to adjust the patient? Is there a metastatic lesion? 

 
All we know is the patient had to get injections of steroids and pain-killers and there is still no definitive diagnosis because NO ONE took the time to figure out why… before treating. Not the chiropractor or the medical doctor shoving drugs into the patient without knowing what is wrong.

 
One of my dearest friends died because the orthopedist neglected to fully diagnose his shoulder problem and kept injecting him with steroids. He had renal cell carcinoma (kidney cancer) and the steroid was a contraindication. By the time I got to him and ordered a CAT Scan, the vertebrate was the metastatic region and he eventually died; height 5’ 6” weighing 55 lbs. at 50 years old BECAUSE an earlier diagosis was not made simply because the doctor neglected to take an image. 

 
You want to make an argument not to image young people…I have issues with that, but in an older popuation… I believe it is highly irresponsible. STOP GUESSING and BE A DOCTOR! We treat lives and are not simply vertebtate schleppers!!!!


 
 
Respectfully,
 



Mark Studin DC, FASBE(C), DAAPM, DAAMLP

Adjunct Associate Professor of Chiropractic, University of Bridgeport, College of Chiropractic
Adjunct Professor, Division of Clinical Sciences, Texas Chiropractic College
Educational Presenter, Accreditation Council for Continuing Medical Education Joint Partnership with the State University of New York at Buffalo, School of Medicine and Biomedical Sciences

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