Chiari Malformation Type I, presenting as scapulothoracic pain: a case report

Worth, David R., and Milanese, Steven (2012) Chiari Malformation Type I, presenting as scapulothoracic pain: a case report. Manual Therapy, 17 (2). pp. 172-174.

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Patients presenting with recalcitrant symptoms, which are resistant to a range of physical interventions over an extended period of time, need to be examined with care. A 'forensic' approach to the assessment of these patients, with a sensitive approach to the results of the test procedures is required to ensure the practitioner does not miss the more obscure causes. This case report presents a patient who was referred for a clinical assessment for long standing scapular pain, which had been labelled myofascial pain. Through a thorough approach to examination a number of flags appeared which suggested a need for further investigation. These investigations identified that the patient demonstrated a Chiari Malformation Type 1. On review 5 months following neurosurgical intervention her symptoms were significantly reduced. Chiari Malformations Type 1 are often diagnosed in adulthood when symptoms usually first appear. These symptoms may mimic those found with musculoskeletal conditions. Whilst we lack specific clinical tests for this condition, a thorough assessment should identify sufficient 'flags' for referral for further investigations.

Item ID: 22683
Item Type: Article (Research - C1)
ISSN: 1532-2769
Keywords: Chiari malformation, scapular pain, forensic physiotherapy
Date Deposited: 01 Aug 2012 09:49
FoR Codes: 11 MEDICAL AND HEALTH SCIENCES > 1109 Neurosciences > 110904 Neurology and Neuromuscular Diseases @ 50%
11 MEDICAL AND HEALTH SCIENCES > 1117 Public Health and Health Services > 111709 Health Care Administration @ 50%
SEO Codes: 92 HEALTH > 9202 Health and Support Services > 920203 Diagnostic Methods @ 20%
92 HEALTH > 9299 Other Health > 929999 Health not elsewhere classified @ 80%
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