Chan Aaron Ka-Chun, Ng Gabriel Siu Nam, Cheong Benjamin Kah Chun, Ng Kenny Kim Pong, Chu Eric Chun-Pu
Chiropractic and Physiotherapy Centre, New York Medical Group, Hong Kong, CHN.
Medical Oncology, reVIVE Oncology and Cancer Centre, Hong Kong, CHN.
Cureus. 2023 May 31;15(5):e39810. doi: 10.7759/cureus.39810. eCollection 2023 May.
Cases of lumbar and gluteal pain are commonly encountered in chiropractic clinics, with a broad differential diagnosis primarily centered on musculoskeletal conditions. This report presents the second documented case of sacral chordoma diagnosed at a chiropractic clinic and emphasizes the importance of considering alternative diagnoses and interdisciplinary collaboration in patient care. A 42-year-old man presented to a chiropractic clinic with complaints of lumbar and gluteal pain. The initial conservative management based on a presumptive musculoskeletal diagnosis was ineffective. Suspicion of an alternative etiology prompted a referral for imaging, which revealed a sacral chordoma. An interdisciplinary collaboration involving orthopedic surgeons, oncologists, radiologists, and other healthcare professionals was initiated to optimize the treatment outcomes of this rare and aggressive tumor. This case report underscores the importance of maintaining a high index of suspicion in cases of musculoskeletal presentations in chiropractic clinics and the critical role of advanced imaging in establishing a definitive diagnosis. Interdisciplinary collaboration is essential for managing complex conditions such as sacral chordomas, ensuring the delivery of the highest quality of care, and optimizing patient outcomes. Chiropractors play a crucial role in identifying, referring, and contributing to the management of patients with complex presentations as part of a comprehensive multidisciplinary treatment plan.
腰椎和臀部疼痛的病例在整脊诊所中很常见,其广泛的鉴别诊断主要集中在肌肉骨骼疾病上。本报告介绍了在整脊诊所诊断出的第二例骶骨脊索瘤病例,并强调了在患者护理中考虑其他诊断和跨学科合作的重要性。一名42岁男性因腰椎和臀部疼痛就诊于一家整脊诊所。基于推测的肌肉骨骼诊断进行的初始保守治疗无效。对其他病因的怀疑促使其转诊进行影像学检查,结果显示为骶骨脊索瘤。于是启动了一个由骨科医生、肿瘤学家、放射科医生和其他医疗专业人员参与的跨学科合作,以优化这种罕见且侵袭性肿瘤的治疗效果。本病例报告强调了在整脊诊所对肌肉骨骼症状保持高度怀疑的重要性,以及先进影像学在确立明确诊断中的关键作用。跨学科合作对于管理诸如骶骨脊索瘤等复杂病症、确保提供最高质量的护理以及优化患者治疗效果至关重要。作为全面多学科治疗计划的一部分,整脊师在识别、转诊以及参与复杂病症患者的管理方面发挥着关键作用。