Chu Eric Chun-Pu, Yau Kristy, Yun Steve Ming Hei
Chiropractic and Physiotherapy Center, New York Medical Group, Hong Kong, CHN.
Cureus. 2023 Aug 29;15(8):e44312. doi: 10.7759/cureus.44312. eCollection 2023 Aug.
Spondylodiscitis is a rare but severe condition characterized by spinal and paraspinal infections that will present to healthcare providers, including chiropractors, because of neck pain. Patients who undergo peritoneal dialysis for end-stage renal disease or have a complex medical history may present with musculoskeletal complaints with complicated and uncommon underlying causes. This report reviews the possible relationship between spinal infection and dialysis, as well as the role of the chiropractor in identifying and managing critical conditions. A 66-year-old Asian man undergoing peritoneal dialysis presented to a chiropractic clinic with pain in the left arm. The patient did not present with a fever. Upon examination, the upper limb muscle strength and reflexes were diminished. Neck pain was also experienced during the range of motion examination, and movement was limited in all directions. Magnetic resonance imaging was ordered. The patient was diagnosed with acute spondylodiscitis. Due to its nonspecific presentation, patients with severe and urgent cases, such as spondylodiscitis, may present to chiropractic offices to seek conservative treatment of pain symptoms. This report highlights the potential role of chiropractors in the early detection and management of complex conditions such as spondylodiscitis in patients on chronic dialysis.
脊椎椎间盘炎是一种罕见但严重的疾病，其特征为脊柱和脊柱旁感染，因颈部疼痛而就诊于包括脊椎治疗师在内的医疗服务提供者。接受终末期肾病腹膜透析或有复杂病史的患者可能会出现肌肉骨骼方面的主诉，且潜在病因复杂且不常见。本报告回顾了脊柱感染与透析之间可能存在的关系，以及脊椎治疗师在识别和管理危急情况中的作用。一名66岁接受腹膜透析的亚洲男性因左臂疼痛就诊于一家脊椎治疗诊所。该患者未发热。检查时，上肢肌肉力量和反射减弱。在活动范围检查期间也出现颈部疼痛，且各个方向的活动均受限。于是安排了磁共振成像检查。该患者被诊断为急性脊椎椎间盘炎。由于其表现不具特异性，患有严重急症（如脊椎椎间盘炎）的患者可能会前往脊椎治疗诊所寻求疼痛症状的保守治疗。本报告强调了脊椎治疗师在早期发现和管理慢性透析患者中诸如脊椎椎间盘炎等复杂病症方面的潜在作用。
