Green BN, "Chiropractic Management of a Case of Combined Osteoarthrosis andPsoriatic Arthritis"   Journal of Sports Chiropractic andRehabilitation. 2000  Sep;  14(3): 75-83

ABSTRACT:

Objective: To describe and discusses the management of a patient presenting withosteoarthrosis and concomitant psoriatic arthritis using chiropractic adjustments,nutritional guidance, soft tissue strategies and exercise. Clinical Features: A 38 yearold male had cervical and thoracic stiffness and soreness of eight years duration that hadnot responded favorably to previous medical and chiropractic care. He consumed up to 4000mg. of pain relievers a day. The following findings were present: psoriatic skin lesions,limited cervical and thoracic range of motion, elevated erythrocyte sedimentation rate,radiographic findings of osteoarthrosis in the cervical and thoracic spine and psoriaticarthritis in the left hand, left hip and left sacroiliac joint. The clinical diagnosis wasosteoarthrosis of the cervical and thoracic spine and inactive psoriatic arthritis of theleft fifth finger, left hip and left sacroiliac joint. Intervention and Outcome: Gradefour mobilization to the cervical and thoracic spine, one chiropractic adjustment perspinal region each week for twelve weeks was provided, active stretching of the samespinal regions, aerobic exercise and dietary modifications were implemented from thebeginning of care. After twelve weeks the patient had achieved maximal clinicalimprovement experiencing pain free periods for up to twelve days without the use of painrelievers. The patient was followed up for one month and maintained improvements.Conclusion: Management of a patient with osteoarthrosis in the cervical and thoracic spineand concomitant inactive psoriatic arthritis of the hand and pelvis by a chiropracticrehabilitation program that included manipulation of joints, soft tissue therapies,exercise and nutritional recommendations is discussed. Based upon previous care providedto the patient, it seemed that this type of program was necessary to resolve the chiefcomplaint.

Anderson GB; Lucente T; Davis AM; Kappler RE; Lipton JA; Leurgans S, "Acomparison of osteopathic spinal manipulation with standard care for patients with lowback pain. N Engl J Med 1999 Nov 4;341(19):1426-31.

ABSTRACT:

BACKGROUND: The effect of osteopathic manual therapy (i.e., spinal manipulation) inpatients with chronic and subchronic back pain is largely unknown, and its use in suchpatients is controversial. Nevertheless, manual therapy is a frequently used method oftreatment in this group of patients. METHODS: We performed a randomized, controlled trialthat involved patients who had had back pain for at least three weeks but less than sixmonths. We screened 1193 patients; 178 were found to be eligible and were randomlyassigned to treatment groups; 23 of these patients subsequently dropped out of the study.The patients were treated either with one or more standard medical therapies (72 patients)or with osteopathic manual therapy (83 patients). We used a variety of outcome measures,including scores on the Roland-Morris and Oswestry questionnaires, a visual-analogue painscale, and measurements of range of motion and straight-leg raising, to assess the resultsof treatment over a 12-week period. RESULTS: Patients in both groups improved during the12 weeks. There was no statistically significant difference between the two groups in anyof the primary outcome measures. The osteopathic-treatment group required significantlyless medication (analgesics, anti inflammatory agents, and muscle relaxants) (P< 0.001)and used less physical therapy (0.2 percent vs. 2.6 percent, P<0.05). More than 90percent of the patients in both groups were satisfied with their care. CONCLUSIONS:Osteopathic manual care and standard medical care had similar clinical results in patientswith subacute low back pain. However, the use of medication was greater with standardcare.

Mestan MA; Bustin GL; Wagner LA, "Chiropractic care and ochronoticarthropathy" J Manipulative Physiol Ther 1999 Sep;22(7):473-7.

ABSTRACT:

OBJECTIVE: To discuss the case of a patient with ochronotic arthropathy whose symptomswere treated with chiropractic care. An emphasis is placed on this condition'sradiographic features. CLINICAL FEATURES: A 59-year-old woman with pain in her low back,right knee, and left ankle sought chiropractic evaluation. Black pigmentation was found inthe sclera of both eyes, and homogentisic acid was present in the urine. Orthopedicevaluation revealed uncomplicated, nonspecific joint pain, and radiographs demonstratedcharacteristic spinal changes. INTERVENTION AND OUTCOME: The patient was treated withchiropractic manipulation, physiotherapy modalities, bracing, and exercises. This type oftherapy was successful in reducing the symptoms and helped decrease the severity andfrequency of acute exacerbations. CONCLUSION: Ochronotic arthropathy is a rare metabolicdisorder that can be diagnosed from spinal radiographs. Chiropractic care is anappropriate tool for reducing its symptomatology.

Daumen-Legre V; Lafforgue P; Champsaur P; Chagnaud C; Pham T; Kasbarian M; AcquavivaPC, "Anteroposterior atlantoaxial subluxation in cervical spine osteoarthritis:case reports and review of the literature." J Rheumatol 1999 Mar;26(3):687-91.

ABSTRACT:

Nontraumatic anteroposterior atlantoaxial subluxation (AAS) has been described inseveral rheumatic or inherited disorders, especially rheumatoid arthritis and to a lesserextent the inflammatory spondyloarthropathies. We describe AAS secondary to osteoarthritis(OA) of the cervical spine in a 76-year-old man and a 73-year-old woman with severecervical OA, symptomatic C1-C2 facet joints, and signs of generalized OA. Only 6 similarcases exist in the literature. OA should be added to the causes of AAS, and conversely AASshould be assessed in cases with severe OA of the upper cervical spine.

Gottlieb MS, "Conservative management of spinal osteoarthritis with glucosaminesulfate and chiropractic treatment." J Manipulative Physiol Ther 1997Jul-Aug;20(6):400-14.

ABSTRACT:

OBJECTIVE: To evaluate the rationale behind the most commonly used treatments ofosteoarthritis, including nonsteroidal anti-inflammatory drugs (NSAIDs), and to assessmore effective conservative treatment options. SUMMARY OF BACKGROUND DATA: This reviewincludes a description of the pathophysiology and prevalence of osteoarthritis, jointphysiology and NSAID treatment of osteoarthritis, as well as side effects on joints, thegastrointestinal tract, kidneys and livers. Several studies of conservative treatment,consisting of supplementation of glucosamine sulfate (which occurs naturally in the humanbody), exercise, and the use of chiropractic treatment for maintaining joint function andpreventing further destruction, are reviewed. DATA SOURCES: A computerized search ofMedline using the key indexing terms osteoarthritis, degenerative joint disease,nonsteroidal anti-inflammatory drugs, glucosamine sulfate, chiropractic and manipulation.RESULTS: Numerous studies wee obtained under each subheading and reviewed by category.Human and animal-model studies are described. CONCLUSION: The rationales for using NSAIDsin the treatment of osteoarthritis is controversial and openly contested. Given thedetrimental effects of NSAIDs on joints and other organs, their use should be discouragedand their classification as a first choice conservative treatment should be abolished. Atruly effective and conservative approach to the treatment of osteoarthritis should include chiropractic manipulation, essential nutrient supplementation, exogenousadministration of glucosamine sulfate and rehabilitative stretches and exercises tomaintain joint function. Because there is no correlation between pain levels and theextent of degeneration detected by radiographic or physical examination, conservativetreatment should be initiated and sustained based on functional, objective findings andnot strictly on how the patient feels. The use of NSAIDs should be limited to thetreatment of gross inflammation and analgesics should only be used in the short-term whenabsolutely necessary for pain palliation. The present conservative approach could lead notonly to a better quality of life but also to the saving of health care dollars by reducingthe iatrogenic morbidity and mortality associated with NSAID use.

Hallas B; Lehman S; Bosak A; Tierney S; Galler R; Jacovina P; Scandalis TA; Wells M,"Establishment of behavioral parameters for the evaluation of osteopathictreatment principles in a rat model of arthritis." J Am Osteopath Assoc1997 Apr;97(4):207-14.

ABSTRACT:

Unilateral arthritis was produced in rats by use of methylated bovine serum albumin ina model of antigen-induced arthritis. The progression of arthritis was measured bycomputerized motion analysis, bilateral joint circumference, voluntary extension force ofthe hindlegs, and length of ankle extension. Animals with induced arthritis were assignedto treated and untreated groups on the basis of approximately equal deficits by theparameters measured. A third group of rats, which did not have arthritis induced andreceived no treatment, served to establish mean normal parameters. Modified techniques ofmuscle energy, passive movement of the ankle and knee, and passive myofascial stretch wereapplied to the animals, and the animals were exercised in a mechanized exercise wheel.Parameters associated with gait were examined by computerized motion analysis of walking.Animals treated with manipulation and exercise improved significantly relative tountreated animals with antigen-induced arthritis in vertical ankle lift, ankle-based andfoot-based stride lengths, knee circumference, and normalized extension of the ankle. Theresults demonstrate that the parameters identified can be used to detect functionaldeficits and significant improvement from those deficits can be derived from anonpharmacologic treatment paradigm that includes osteopathic manipulation and exercise inan animal model of arthritis. These parameters may be useful in the identification of therelative benefits of independent treatment variables including frequency of osteopathicmanipulation and exercise and the relative benefits of each in this model. Also, they mayelucidate how these treatments produce their beneficial effects clinically.

Buckwalter JA., "Joint distraction for osteoarthritis." Lancet1996 Feb 3;347(8997):279-80..

Ellis P, "A Putative Role of Cervical Meniscoids in FacetArthrosis  " Conference Proceedings of the ChiropracticCentennial 1995  Jul;  235

ABSTRACT:

Introduction: Variation in cervical zygapophyseal meniscoid bodies considered among thecontributing factors in etiology of facet arthrosis, a form of degenerative joint disease.A proposed mechanism for this pathology is the chronic intersegmental hypomobility and itssequelae produced in part by larger, dense intraarticular meniscoid bodies. Methods: Toevaluate this relationship, cervical joints were dissected and evaluated macroscopicallyand microscopically for meniscoid bodies and evidence of arthrosis. Results: For thesestudies 80 joints, from 5 cadavers were evaluated. From these, 26 joints were found tohave arthrosis and 18 joints demonstrated meniscoids present. Of the 26 joints witharthrosis, 11 had meniscoids present. However, the remaining 54 joints, without arthrosishad only 7 meniscoids. These findings represent a significant (p=0.023) increase in theincidence of meniscoids in joints with arthrosis (42%) as compared to those joints withoutarthrosis (13%). Conclusion: These data support the hypothesis that meniscoid formationmay predispose to joint arthrosis. Studies are in progress to further evaluate thispossible relationship.

Hendler N, Jamison R, Kahn Z, Morrison C, Piper J, "The Relationship ofDiagnosis and Weather Sensitivity in Chronic Pain Patients " Journal ofthe Neuromusculoskeletal System 1995  Spr; 3(1): 10-5.

ABSTRACT:

Chronic pain patients often report weather sensitivity. Although case studies based ona single ailment or diagnosis have been described, very little research has been done tocategorize a range of diagnoses influenced by climatic conditions. To assess thisrelationship, demographic and diagnostic data on 97 patients with chronic pain werecorrelated with responses indicating the effect of the weather on each patient's pain.Results demonstrated that weather consistently worsened pain for certain diagnoses.Percentages of patients affected were as follows: unstable lumbar spine (100%), bulgingdisc (85%), carpal tunnel syndrome (78%), neural foraminal stenosis (78%), degenerativedisc disease (78%), thoracic outlet syndrome (76%), facet disease (74%), radiculopathy(73%), and spondylosis (73%). Patients least affected included those with diffusemyofascial syndrome (50%) and temporal mandibular joint syndrome (58%). In general, thosepatients most frequently reporting weather-sensitive pain, had a neural and/or bonycomponent as the etiology of their pain conditions. Those with muscular pain reported lessfrequently the effect of weather on their pain.

Helders P, Hogeweg J, Oostendorp R, "Soft-Tissue Compliance Measurements in theSpinal Region of Children With Juvenile Chronic Arthritis Compared With Healthy Childrenand Adults "  J Manipulative Physiol The. 1995  May;  18(4): 226-32.

ABSTRACT:

Objective: Study 1. To compare paraspinal soft-tissue compliance in asymptomatic(healthy) adults with children and to define reference values in children. Study 2. Todetermine whether the reference values in asymptomatic children differ from children withjuvenile chronic arthritis (JCA). Study Design: A tissue-pressure-compliance meter (TPCM)was used in the paraspinal region of 69 asymptomatic children, 28 asymptomatic adults andin 57 children with JCA. The tissue compliance was assessed paraspinally at level C6, T1,T3, T6, T10, L3, and L5. Main Findings: Study 1. Differences between asymptomatic childrenand adults were not significant, except for the thoracolumbar junction, i.e., area T10, L1and L3. Asymptomatic men showed a greater amount of displacement at area C6; adultasymptomatic women at area L3 and L5. The cervical and lumbar areas were shown to have thegreatest amount of displacement and the thoracic area the least. Study 2. No significantdifferences were found between the compliance of the JCA group and the asymptomatic group,except for paraspinal area L3. Conclusion: Study 1. The curvature within the spinal regionin adults and children may have influenced the amount of soft-tissue displacement; sexualmaturation may have affected soft-tissue displacement as well. Study 2. Paraspinalsoft-tissue compliance exhibited no alterations in JCA that could be segmentally relatedto inflamed joints.

Jamison J, "The Management of Rheumatoid Arthritis: Considerations forChiropractic Practice"   Chiropractic Journal of Australia 1994  Sep; 24(3):  83-90

ABSTRACT:

Objective: To contribute to the chiropractic management of rheumatoid arthritis byproviding: i) an overview of current nutritional management, and ii) a summary of commondrug side-effects. Data Sources: Peer reviewed refereed journals. Study Selection: VariousData Extraction and Synthesis: This was undertaken with a view to providing practitionerswith a appreciation of how contemporary knowledge in biochemistry and physiology is beingused as a basis for nutritional intervention in practice. Current nutritional managementof rheumatoid arthritis is reviewed, and practitioners are reminded of the problems whichrheumatoid patients may suffer as a result of their drug therapy. Conclusion: Although thenutritional management of rheumatoid arthritis requires further clinical validation, thereis strong evidence to suggest that patients on appropriate nutritional supplementation mayreduce their intake of anti-rheumatoid drugs without suffering deterioration in theirarthritis.

Mierau D, Sibley J, Tibbles A, "Destructive Arthritis of the Hip in a Patientwith Crohn's Disease"   J Manipulative Physiol The. 1993  Dec:16(9):  601-4

ABSTRACT:

Objective: Isolated destructive peripheral arthropathy is a rare complication ofCrohn's disease. We describe the clinical course and radiographic findings of such a case.Clinical features: A 28-year-old male presented to our chiropractic clinic with chronicleft hip pain. The patient was known to have Crohn's disease. Five years earlier thegastrointestinal symptoms resolved with a brief course of prednisone. However, the lefthip pain continued. A radiograph of the left hip was read as normal. Repeat radiograph, 2yr later, revealed destructive changes of the left hip and, in retrospect, earlydestructive changes could be seen on the initial radiograph. Intervention and Outcome: Thediagnosis, in this case, was destructive arthritis of the left hip secondary to Crohn'sdisease. The treatment selected in this case was observation and nonsteroidalanti-inflammatory drug use. Conclusion: This diagnosis, a relatively rare complication ofCrohn's disease, should be considered in a young adult patient with Crohn's disease andpersistent peripheral joint pain.

Tibbles AC;,Mierau DR, Sibley, "Destructive arthritis of the hip in a patientwith Crohn's disease". Manipulative Physiol Ther 1993 Nov-Dec;16(9):601-4.

ABSTRACT:

OBJECTIVE: Isolated destructive peripheral arthropathy is a rare complication ofCrohn's disease. We describe the clinical course and radiographic findings of such a case.CLINICAL FEATURES: A 28-yr-old male presented to our chiropractic clinic with chronic lefthip pain. The patient was known to have Crohn's disease. Five years earlier thegastrointestinal symptoms resolved with a brief course of prednisone. However, the lefthip pain continued. A radiograph of the left hip was read as normal. Repeat radiograph, 2yr later, revealed destructive changes of the left hip and, in retrospect, earlydestructive changes could be seen on the initial radiograph. INTERVENTION AND OUTCOME: Thediagnosis, in this case, was destructive arthritis of the left hip secondary to Crohn'sdisease. The treatment selected in this case was observation and nonsteroidalanti-inflammatory drug use. CONCLUSION: This diagnosis, a relatively rare complication ofCrohn's disease, should be considered in a young adult patient with Crohn's disease andpersistent peripheral joint pain.

Reggars J, "The Cardiovascular Manifestations of Certain RheumatologicalDisorders"   Comsig Review 1993  Nov;  2(3):  60-3.

ABSTRACT:

Chiropractors and other practitioners of spinal manipulative therapy are often calledupon to treat the musculo-skeletal symptoms of patients suffering from a wide variety ofrheumatological disorders. The SMT practitioner may be the primary contact, oralternatively these patients may seek help from the SMT practitioner after diagnosis froma medical practitioner. Either way it is essential that whoever treats these patients fortheir musculo-skeletal symptoms is fully cognisant of the cardiovascular manifestationswhich may accompany rheumatological disorders and their possible cardiovascularmanifestations.

Curl DD; Stanwood G, "Chiropractic management of capsulitis and synovitis ofthe temporomandibular joint." J Orofac Pain 1993 Summer;7(3):283-93.

ABSTRACT:

Localized inflammatory conditions (eg, synovitis and capsulitis) of thetemporomandibular joint are commonly seen in clinical practice. Regardless of theirfrequency of occurrence, these conditions must be differentially diagnosed from conditionsthat also may cause pain in the temporomandibular joint region. Capsulitis or synovitisshould be considered if such pain is present and historical, physical, and laboratoryfindings do not indicate a referred pain phenomena or systemic, tumorous, or infectiousinvolvement. This article reviews the clinical characteristics, etiology, physicalexamination methods, treatment, and prognosis for capsulitis and synovitis, and threecases that illustrate these conditions are reported

Lantz C, Pinto A, "Response of Psoriatic Arthritis Patient to ChiropracticAdjustments "  Proceedings of the Int'l Conference on SpinalManipulation 1991  Apr;  72-5

ABSTRACT:

(Authors Introduction): A 56 year-old male caucasian suffered from psoriasis for 18years and was diagnosed 5 years ago with psoriatic arthritis (PA). He has a family historyof PA. X-rays confirmed classic PA. Several years of medical treatment provided littlerelief as the condition progressed relentlessly. Pain had become a significant problem.All ranges of movement (ROM) were severely restricted and sacroiliac articulations (SIA)were ankylosed bilaterally. Other classic signs included cocktail sausage digits and skinlesions throughout the body. Cervical flexion/extension studies revealed no upper cervicalinstability and it was deemed safe to perform cervical adjustments. Initial lumbartreatment produced such dramatic improvement it was decided to more carefully documentresults of cervical management. Toggle/recoil, was utilized to adjust C1 allowingevaluation of an isolated vector of vertebral movement and the effects of such procedures.In this patient with PA and extensive spinal ankylosis, the response was dramaticallypositive. Increases in all the cervical but not in the lumbar spine, suggest a specificeffect of the cervical adjustments on ROM. Decreases in CROM post-adjustment suggestsactivation of a guarding mechanism. The qualitatively different response of cervicalextension supports this idea. Decreases in clinical symptoms paralleled increased ROM.

Berkson DL, "Osteoarthritis, chiropractic, and nutrition: osteoarthritisconsidered as a natural part of a three stage subluxation complex: its reversibility: itsrelevance and treatability by chiropractic and nutritional correlates." MedHypotheses 1991 Dec;36(4):356-67.

ABSTRACT:

It is proposed that chiropractic and nutritional treatment contribute to theamelioration and perhaps reversal of osteoarthritis (OA). It is further proposed that thechiropractic manipulative thrust, is in effect, treating dysfunctional bio-mechanics ofjoints, affecting positive cartilaginous change. The pathophysiology and multi-factorialcauses of OA are reviewed. New interpretations of the literature surrounding OA arediscussed which offer arguments for OA's treatment and reversal through chiropracticmanipulation and nutritional support. Presented is a new model of the chiropractic conceptof subluxation (abnormal joint complex resulting in fixation or decrease in normal rangeof motion) and the chiropractic manipulative thrust. The associated histologic correlatesare also discussed. A review of the literature of anti-inflammatory and muscle/jointcomplex supportive nutrients appropriate for OA is presented. Finally, a completetreatment protocol for OA is summarized.

Hicks L, "The chiropractic medical management of hyperuricemia and goutyarthritis"   American Chiropractor. 1991  Mar; 13(3):12-15

ABSTRACT:

As any chiropractic physician is aware, Gout is a disorder of purine

metabolism. It is characterized by hyperuricemia and recurrent attacks of acutearthritis which may be chronically deforming. The acute episodes present all of thecardinal signs of inflammation. The affected periarticular structures are red, hot,swollen and exquisitely painful. The joint affectation arises as elevated levels ofsoluble serum urate precipitates under locally acidic conditions or in bodily regions ofrelative circulatory stasis, such as may be seen in the more dependent joints of the lowerextremities.

Lantz C, Pinto A, "Response of Psoriatic Arthritis Patient to ChiropracticAdjustments"   Proceedings of the Int'l Conference on SpinalManipulation. 1991  Apr: 72-5

ABSTRACT:

(Authors Introduction): A 56 year-old male caucasian suffered from psoriasis for 18years and was diagnosed 5 years ago with psoriatic arthritis (PA). He has a family historyof PA. X-rays confirmed classic PA. Several years of medical treatment provided littlerelief as the condition progressed relentlessly. Pain had become a significant problem.All ranges of movement (ROM) were severely restricted and sacroiliac articulations (SIA)were ankylosed bilaterally. Other classic signs included cocktail sausage digits and skinlesions throughout the body. Cervical flexion/extension studies revealed no upper cervicalinstability and it was deemed safe to perform cervical adjustments. Initial lumbartreatment produced such dramatic improvement it was decided to more carefully documentresults of cervical management. Toggle/recoil, was utilized to adjust C1 allowingevaluation of an isolated vector of vertebral movement and the effects of such procedures.In this patient with PA and extensive spinal ankylosis, the response was dramaticallypositive. Increases in all the cervical but not in the lumbar spine, suggest a specificeffect of the cervical adjustments on ROM. Decreases in CROM post-adjustment suggestsactivation of a guarding mechanism. The qualitatively different response of cervicalextension supports this idea. Decreases in clinical symptoms paralleled increased ROM.

MacDonald RS; Bell CM, "An open controlled assessment of osteopathicmanipulation in nonspecific low-back pain." Spine 1990 May;15(5):364-70.

ABSTRACT:

An open controlled pilot trial on nonspecific low-back pain sufferers demonstratedresponsiveness to osteopathic manipulation of some patients presenting with pain durationsof 14 to 28 days. No response was demonstrated in those with shorter episodes atpresentation. The advantage to manipulated patients was maximal between 1 and 2 weeksafter commencing treatment, but was not discernible after 4 weeks. The demonstration of asimilar responsive stratum by other investigators, with both teams totally unaware of eachother's work during data collection, suggests a high degree of reliability for thisfinding.

Decava J, "The arthritides"   Digest of ChiropracticEconomics  1990 ; 32(5):32-39

Nelson W, "[letter] Acute Lumbosacral Myofascitis Associated with Reiter'sDisease: Case Report"   J Manipulative Physiol Therp  1989  Jul; 12(3): 240-1.

Newman CF; Downes NJ; Tseng RY; McProud LM; Newman LK, "Nutrition-relatedbackgrounds and counseling practices of doctors of chiropractic."

J Am Diet Assoc 1989 Jul; 89(7):939-43.

ABSTRACT:

A questionnaire was designed and mailed to the entire membership (no. = 438) of the SanFrancisco Bay Area Chiropractic Society to determine their nutrition education backgroundsand counseling practices and the relationship of backgrounds and counseling practices andthe relationship of backgrounds and information resources to counseling practices.Results, based on the 23% response rate, indicated that the hours of formal nutritioneducation in chiropractic college varied widely in the five categories of responses fromzero to more than 120, with the median respondent falling in the median category (81 to100 hours). Sixty percent of the respondents indicated that they provided nutritioninformation to their patients on a routine basis, and 38% provided information on requestonly. The major forms of nutrition information dissemination were counseling (87%) andwritten materials (74%). The majority of respondents reported that they diagnoseosteoporosis, arthritis, and allergies and use nutrition treatments for those disorders asa part of overall therapy. Chiropractic journals and texts were the most frequently usedsources of nutrition information. Awareness of the educational backgrounds of registereddietitians correlated positively with the use of dietitians as a resource for nutritioninformation (p less than .005). The survey results suggest a need for dietitians to becomeinvolved in the nutrition-related practices of chiropractors as sources for informationand referral.

Irowa G, "Acute lumbosacral myofascitis associated with Reiter'sdisease "  J Manipulative Physiol The  1988  Dec;11(6): 500-504.

ABSTRACT:

Reiter's syndrome is an arthritic condition that has as its main featurespolyarthritis, conjunctivitis and urethritis. It is not typically associated withlumbosacral symptomatology. This paper reports a case of Reiter's syndrome withlumbosacral myofascitis. Therapy and management are discussed.

Bolton P, Ware A, "Degenerative joint disease in the cervical spine ofchiropractic patients"   Journal of the Australian ChiropracticAssociation  1988  Jun;  18(2): 51-4 .

ABSTRACT:

The plain radiographs of the cervical spine of two hundred adult who had consulted achiropractor were reviewed and examined for signs of degenerative joint disease. Inaddition, the location of greatest stress and strain was determined on each neutrallateral cervical radiograph using a previously described method. Forty percent of thecervical spine radiographic series had evidence of degenerative joint disease. Thedegenerative joint disease was most commonly found at the C5-C6 motion unit. The locationof greatest stress and strain was most commonly found at the C4 vertebral body. Itslocation on radiographs with degenerative joint disease was not significantly different(p>0.05) from its location on those radiographs without degenerative joint disease.Analysis of scaled deviance indicated that the location of degenerative joint disease andlocation of greatest stress and strain were unrelated. There was no apparent difference inthe prevalence of degenerative joint disease of the cervical spine of subjects presentingto the chiropractor compared with a previous study of asymptomatic subjects who had nohistory of cervical spine trauma, pathology or pain.

Meiteen G, "Atlanto-axial instability in psoriatic arthritis: a case report " Journal of the Canadian Chiropractic Association 1988   Jun; 32(2):  85-87.

ABSTRACT:

Psoriatic arthritis involving the spine is uncommon. However, when does occur, atlanto-axial instability may occur. Clinical and radiographic aspects of psoriatic arthritis are reviewed and illustrated with a case report.

Grier A, Proctor D, "Chiropractic management of a patient with arthritis associated with systemic lupus erythematosus "  Pain Clinic  1988 ;2: 163-168

ABSTRACT:

The management of chronic arthritis experienced by many patients as a manifestation of systemic lupus erythematosus (SLE) presents clinicians with a challenge. The objective of this paper is to review and define SLE, its signs and symptoms, chiropractic care and manipulation. In addition a review of the multidisciplinary approach to management of SLE patients, which can include chiropractic care, is provided. Goals for assessment of treatment are outlined. Chiropractic management of lupus patients includes manipulation, range of motion exercise techniques, massage, heat and/or ice and lifestyle counseling. Therapeutic goals must be determined and continually reassessed. Objective indicators of the efficacy of manipulative therapy include increased joint range of motion and a demonstrable decrease in medication intake. Subjective indicators include a decrease in pain, decreased fatigue, and an increase in general well-being. A case history is presented where chiropractic treatment was used

Dishman RW, "Static and dynamic components of the chiropractic subluxation complex: a literature review." J Manipulative Physiol Ther 1988 Apr;11(2):98-107.

ABSTRACT:

Intervertebral dysfunction refers to a biomechanical fault which is abnormal in both its dynamic and static components. A subluxation may be considered as being fixated and also slightly malpositioned in one or more axes of rotation. Subluxation may be considered as one component of a complex or syndrome of intervertebral dyskinesia, dysarthrosis or dysfunction. The biochemical and histological components explain some of the pain mechanisms, tissue changes and residual effects of acute and chronic intervertebral fixation and the need for repeated spinal manipulations and prolonged care. Interexaminer reliability studies indicate that a standard method of motion palpation is quite feasible and accurate. X-ray evidence of dyskinesia shows promise as a means of documenting subluxation fixations.

McGrath H; McCormick C; Carey ME, "Pyogenic cervical osteomyelitis presenting as a massive prevertebral abscess in a patient with rheumatoid arthritis. Am J Med 1988 Feb;84(2):363-5.

ABSTRACT:

Pre-existing rheumatoid arthritis appeared to have masked the diagnosis and contributed to a succession of hazardous events in a 58-year-old man with pyogenic cervical osteomyelitis. A massive prevertebral abscess and near asphyxiation finally led to the diagnosis of an indolent Staphylococcus aureus infection in a course marked by antecedent staphylococcal sepsis, a series of dangerous cervical spine chiropractic manipulations in the presence of advanced bony destruction, and, ultimately, cervical spine bony collapse and gibbus formation. The absence of myelopathy despite long-standing progressive advanced destruction is noteworthy. The roentgenologic documentation of this progression was unique. This appears to be the first fully documented case of cervical spine osteomyelitis presenting as a prevertebral abscess in a patient with rheumatoid arthritis.

Dishman R, "Review of the literature supporting a scientific basis for the chiropractic subluxation complex." J Manipulative Physiol Ther 1985 Sep;8(3):163-74.

ABSTRACT:

A review of the literature reveals strong evidence for both the mechanical model of disease production (structural) and the neurobiological model (functional). Outdated models which attempt to describe a scientific basis for chiropractic theory are inadequate and indeed harmful to the progress and acceptance of chiropractic. Pragmatic or empirical arguments that "Chiropractic works and that's what counts" have served a useful purpose, but now must be augmented by extant research findings. The "paradigm shift" is on. Research investigators around the world are focusing on the multiple components of the chiropractic subluxation complex (CSC), a definitive, provable clinical entity. No longer can "informed" critics support the accusation that "chiropractic practice is based upon irrational, untenable premises." Only a few more pieces of the puzzle need to be fitted into place to produce the "big picture," i.e., the vertebral column is one of the most neglected vital organs in the human body--the sine qua non of the neurobiomechanical system--which influences every structure and function. Historically, its role in maintaining health has been almost totally ignored and for nearly a century chiropractors have battled against the consequences of this neglect. The scientific community is about to see that chiropractic is leading the way in discovering the "new world" in health care. Past, present and future research is discussed.

Bombardier C, Goldsmith C, Helewa A, Lee P, Smythe H, "Epidemiology of musculoskeletal disorders (complaints) and related disability in Canada "   Journal of Rheumatology 1985; 12(6): 1169-73 .

ABSTRACT:

Data on musculoskeletal disorders, collected as part of the Canada Survey were analyzed. 16% of those sampled reported having arthritis, rheumatism or back, limb or joint disorders with a greater prevalence among females and in the older population. In 21% this was associated with limitation of activity with an average of 11 disability days/person/year. Serious back disorders were reported in 4.4% of the population. While the majority of health consultation (53%) were with a physician, a substantial number (34%) were with chiropractors.

Bose R, "Ankylosing spondylitis: Treatment "  American Chiropractor  1982  Jun: 50.

Sandman K, Sandman T, "Rheumatoid arthritis of the cervical spine: examination prior to chiropractic manipulative therapy  J Manipulative Physiol The. 1981;4: 19-20 .

ABSTRACT:

A case is presented in which a 35-year old female, with previously diagnosed rheumatoid arthritis located predominately in the upper extremities and cervical spine, presented to a chiropractic college clinic for evaluation and possible therapy. The prior diagnosis was confirmed through routine physical, orthopedic and roentgenologic examination, however, since the patient was a potential candidate for manipulative therapy, it was decided that the routine films should be supplemented with flexion-extension studies and tomographic studies to evaluate for cervical spine erosion and potential for pathologic atlanto-axial subluxation. The case was determined to have erosive cervical spine changes and an increased atlanto-dental interval (ADI), thus contraindicating manipulative therapy. It was concluded that routine examination procedures may not be sufficient for evaluating this condition prior to manipulative therapy.

Rowe L, Yochum T, "Arthritides of the upper cervical complex "   ACA Journal of Chiropractic  1981 ;15 : S1-10 .

ABSTRACT:

A review of the arthritides involving the upper cervical complex with special emphasis on the radiological presentation, and a discussion on the importance of related spinal manipulative therapy is presented. A synopsis of the normal anatomy, biomechanics and spinographic measurements of the upper cervical complex is reviewed, to establish the basis for interpreting the radiological and pathological changes associated with selected arthritides. Each arthritide is reviewed and clinical correlation of associated signs and symptoms is stressed. The relative contraindications for administering spinal manipulative therapy are discussed.

Rinsky LA; Reynolds GG; Jameson RM; Hamilton RD, "A cervical spinal cord injury following chiropractic manipulation." Paraplegia 1976 Feb;13(4):223-7.

ABSTRACT:

A case is presented of a permanent C4 tetraplegia following chiropractic manipulation of a patient with ankylosing spondylitis. The pertinent literature is reviewed.