Related Experiment Video
Updated: May 25, 2026
07:12
Clinical Efficacy of an Innovative Multidimensional Traction Therapy in Moderate Adolescent Idiopathic Scoliosis
Published on: February 10, 2026
Chiari Malformation Type I, presenting as scapulothoracic pain: a case report
David R Worth1, Steven Milanese
1University of South Australia, 4 Hawker Rd, Aldgate South Australia 5154, Australia. drworth@bigpond.net.au
Manual Therapy
|January 17, 2012
Summary
A forensic approach is crucial for diagnosing rare conditions like Chiari Malformation Type 1, which can mimic musculoskeletal pain. Early neurosurgical intervention significantly reduced symptoms in a patient with long-standing scapular pain.
Area of Science:
- Neurology
- Neurosurgery
- Musculoskeletal Medicine
Background:
- Recalcitrant symptoms resistant to physical interventions require careful evaluation.
- A 'forensic' approach is necessary to identify obscure causes of persistent pain.
- Myofascial pain is a common diagnosis for chronic scapular pain.
Observation:
- A case report details a patient with long-standing scapular pain initially diagnosed as myofascial pain.
- Thorough clinical examination revealed 'flags' necessitating further investigation.
- Investigations identified a Chiari Malformation Type 1 in the patient.
Findings:
- The patient's symptoms significantly reduced 5 months after neurosurgical intervention for Chiari Malformation Type 1.
- Chiari Malformation Type 1 often presents in adulthood with symptoms mimicking musculoskeletal conditions.
- Specific clinical tests for Chiari Malformation Type 1 are lacking.
Implications:
- A comprehensive patient assessment can identify 'flags' for conditions like Chiari Malformation Type 1.
- Neurosurgical intervention can be effective for Chiari Malformation Type 1.
- Healthcare providers should consider neurological causes for persistent, unexplained pain.
Related Concept Videos
01:21Aneurysm II: Clinical Manifestations and Diagnostic Studies
Thoracic, aortic arch and abdominal aneurysms are significant vascular conditions that can present with various clinical manifestations and lead to serious complications. Understanding these manifestations and the appropriate diagnostic studies is essential for effective management and treatment.Thoracic Aortic AneurysmsThoracic aortic aneurysms often remain asymptomatic until they reach a size that impinges on adjacent structures. They typically cause deep, diffuse chest pain that radiates to...
01:29Herniated Intervertebral Disc l: Introduction
Intervertebral disc herniation refers to the displacement of the nucleus pulposus (the gel-like inner core of the disc) through a tear or weakened area in the annulus fibrosus (the outer fibrous ring). The displaced disc material extends beyond the normal boundaries of the disc space and may compress or irritate nearby spinal nerve roots or, less commonly, the spinal cord.Etiology and Risk FactorsHerniation commonly results from degeneration, in which aging reduces disc hydration and...
01:25Pericarditis IV: Nursing Management
Pericarditis, an inflammation of the pericardium, necessitates diligent nursing management to ensure effective patient care and recovery. The initial step in managing pericarditis is a comprehensive patient medical assessment.The patient reports chest pain aggravated by breathing, coughing, and swallowing, which worsens when lying supine. The pain often improves when sitting up and leaning forward. Additional symptoms may include fever, malaise, and, in severe cases, signs of heart failure.
01:22Appendicitis-I: Introduction
The appendix, a small, narrow, blind tube extending from the inferior part of the cecum, is widely regarded as a vestigial organ, having lost much of its original function through evolution. Despite its diminished role, the appendix can become inflamed, a condition known as appendicitis.
Etiology: Appendicitis can arise from various causes, primarily rooted in the obstruction of the appendix lumen. Factors contributing to this obstruction include fecal accumulation, lymphoid hyperplasia and, in...
Etiology: Appendicitis can arise from various causes, primarily rooted in the obstruction of the appendix lumen. Factors contributing to this obstruction include fecal accumulation, lymphoid hyperplasia and, in...
01:24Chronic Pancreatitis I: Introduction
The pancreas, an elongated and flat gland situated behind the stomach, serves a vital function in digesting food and managing blood sugar levels.
Pancreatitis is the inflammation of the pancreas, which occurs when the immune system becomes active and causes swelling, pain, and disruptions in organ function. Pancreatitis can manifest as either an acute or chronic condition.
Acute pancreatitis arises suddenly and lasts for a brief duration, while chronic pancreatitis is a long-term affliction...
Pancreatitis is the inflammation of the pancreas, which occurs when the immune system becomes active and causes swelling, pain, and disruptions in organ function. Pancreatitis can manifest as either an acute or chronic condition.
Acute pancreatitis arises suddenly and lasts for a brief duration, while chronic pancreatitis is a long-term affliction...
01:19Pericarditis II: Clinical Features and Diagnostic Tests
Pericarditis is distinguished by inflammation of the pericardium, the fibrous sac that encases the heart. It can be acute, lasting less than six weeks, or chronic, persisting for over three months. Understanding its clinical manifestations and diagnostic findings is crucial for timely and effective management.Clinical ManifestationsWhile pericarditis can be asymptomatic, it usually presents with characteristic symptoms such as:Chest Pain: The most characteristic symptom of pericarditis is chest...