Retropharyngeal tendinitis of the longus coli muscle is a clinically significant condition that i... more Retropharyngeal tendinitis of the longus coli muscle is a clinically significant condition that is only moderately documented in the literature. Symptoms can mimic pathologies such as meningitis or retropharyngeal abscess. Radiologically, it can also be mistaken ' "for cervical fracture or a calcified stylohyoid ligament. It is characterized by insidious onset of severe progressive neck pain with restricted cervical range of motion. The disease is thought to resemble the same histophysiology as calcific tendinitis of the shoulder and involves the deposition of hydroxyapatite crystals. There appear to be two phases: a non-symptomatic deposition phase and a symptomatic resorptive phase. The underlying mechanism is not fully understood. Various authors have proposed that this clinical syndrome is more prevalent than previously considered.
In the UK Physiotherapy, Chiropractic and Osteopathy are all statutory regulated professions. Tho... more In the UK Physiotherapy, Chiropractic and Osteopathy are all statutory regulated professions. Though guidelines have supported the use of Spinal Manipulative Therapy (SMT) for low back pain (LBP), General Practitioners (GP) referral patterns to the 3 registered professions that perform SMT are generally unknown. A short questionnaire was designed and piloted. Demographic information, patient referral to SMT and the GPs own personal utilisation of SMT were obtained. 385 GP's were contacted representing approximately 20% of the GP's in Wales Autumn 2007. 182 (50.8%) completed questionnaires were returned. Profile characteristics: 2/3 of respondents were male, 79% were 40 years old or older (statistically reflective of the total population of GPs in Wales at that time) and 62% had 20 years or less in practise. Personal use of SMT by GP's: 48 respondents had sought SMT treatment and a further 56% of those that had not previously sought SMT indicated that they would consider ...
Journal of Manipulative and Physiological Therapeutics, 2006
Objective: To discuss the case of a patient with chronic headache. Although not in severe pain at... more Objective: To discuss the case of a patient with chronic headache. Although not in severe pain at time of consultation, signs and symptoms raised concern. The patient later had a cerebrovascular accident. Clinical Features: A 49-year-old man with non-traumatic chronic episodic head and neck pain presented for care. Examination and plain film radiographs were unremarkable, suggesting a mechanical origin for the symptoms; however, information in the case history raised concerns. Intervention and Outcome: The patient was examined and not manipulated by the doctor of chiropractic but referred back to his general practitioner for a second opinion. The following week, the patient was admitted to hospital having had a cerebrovascular accident. Conclusion: The possible indication of the prodrome to a stroke may lie in the case history rather than the examination findings and provocative testing.
Journal of Manipulative and Physiological Therapeutics, 2007
Objective: This case report discusses a patient who presented with right-sided buttock pain of ap... more Objective: This case report discusses a patient who presented with right-sided buttock pain of apparently uncomplicated mechanical origin that was eventually diagnosed as a primary Ewing sarcoma/primitive neuroectodermal tumor of the sacrum. Clinical Features: A 32-year-old male full-time student presented for care with right-sided buttock pain. Intervention and Outcome: After examination, the patient was referred to his general practitioner for urgent magnetic resonance imaging, the report revealed no explanation for the presenting symptoms. After further imaging and biopsy, an eventual diagnosis of Ewing sarcoma/primitive neuroectodermal tumor was reached. The patient died 12 months later. Conclusion: This case highlights a nondiscal cause for cauda equina symptoms. It emphasizes potential diagnostic complexities that may present due to preconceptions based upon the probability of symptoms being related to a specific disease process.
Retropharyngeal tendinitis of the longus coli muscle is a clinically significant condition that i... more Retropharyngeal tendinitis of the longus coli muscle is a clinically significant condition that is only moderately documented in the literature. Symptoms can mimic pathologies such as meningitis or retropharyngeal abscess. Radiologically, it can also be mistaken ' "for cervical fracture or a calcified stylohyoid ligament. It is characterized by insidious onset of severe progressive neck pain with restricted cervical range of motion. The disease is thought to resemble the same histophysiology as calcific tendinitis of the shoulder and involves the deposition of hydroxyapatite crystals. There appear to be two phases: a non-symptomatic deposition phase and a symptomatic resorptive phase. The underlying mechanism is not fully understood. Various authors have proposed that this clinical syndrome is more prevalent than previously considered.
In the UK Physiotherapy, Chiropractic and Osteopathy are all statutory regulated professions. Tho... more In the UK Physiotherapy, Chiropractic and Osteopathy are all statutory regulated professions. Though guidelines have supported the use of Spinal Manipulative Therapy (SMT) for low back pain (LBP), General Practitioners (GP) referral patterns to the 3 registered professions that perform SMT are generally unknown. A short questionnaire was designed and piloted. Demographic information, patient referral to SMT and the GPs own personal utilisation of SMT were obtained. 385 GP's were contacted representing approximately 20% of the GP's in Wales Autumn 2007. 182 (50.8%) completed questionnaires were returned. Profile characteristics: 2/3 of respondents were male, 79% were 40 years old or older (statistically reflective of the total population of GPs in Wales at that time) and 62% had 20 years or less in practise. Personal use of SMT by GP's: 48 respondents had sought SMT treatment and a further 56% of those that had not previously sought SMT indicated that they would consider ...
Journal of Manipulative and Physiological Therapeutics, 2006
Objective: To discuss the case of a patient with chronic headache. Although not in severe pain at... more Objective: To discuss the case of a patient with chronic headache. Although not in severe pain at time of consultation, signs and symptoms raised concern. The patient later had a cerebrovascular accident. Clinical Features: A 49-year-old man with non-traumatic chronic episodic head and neck pain presented for care. Examination and plain film radiographs were unremarkable, suggesting a mechanical origin for the symptoms; however, information in the case history raised concerns. Intervention and Outcome: The patient was examined and not manipulated by the doctor of chiropractic but referred back to his general practitioner for a second opinion. The following week, the patient was admitted to hospital having had a cerebrovascular accident. Conclusion: The possible indication of the prodrome to a stroke may lie in the case history rather than the examination findings and provocative testing.
Journal of Manipulative and Physiological Therapeutics, 2007
Objective: This case report discusses a patient who presented with right-sided buttock pain of ap... more Objective: This case report discusses a patient who presented with right-sided buttock pain of apparently uncomplicated mechanical origin that was eventually diagnosed as a primary Ewing sarcoma/primitive neuroectodermal tumor of the sacrum. Clinical Features: A 32-year-old male full-time student presented for care with right-sided buttock pain. Intervention and Outcome: After examination, the patient was referred to his general practitioner for urgent magnetic resonance imaging, the report revealed no explanation for the presenting symptoms. After further imaging and biopsy, an eventual diagnosis of Ewing sarcoma/primitive neuroectodermal tumor was reached. The patient died 12 months later. Conclusion: This case highlights a nondiscal cause for cauda equina symptoms. It emphasizes potential diagnostic complexities that may present due to preconceptions based upon the probability of symptoms being related to a specific disease process.
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Papers by Annabel Kier