A survey of radiographic impressions on a selected chiropractic patient population

The chiropractic profession relies heavily on conventional radiography for patient clinical evaluation. Although the modality is widely used, there exists surprisingly little descriptive information about the common radiographic findings seen on chiropractic patients. The goal of this study is to provide descriptive data regarding the frequency and type of radiographic findings seen in a convenience sample of chiropractic outpatients.

A group of 300 patient radiographic reports were selected from a chiropractic teaching clinic. The group represented all those reports interpreted by the same chiropractic radiologist over the course of 3 months. Patient information, radiographic impressions and recommendations for further management were tabulated.

In total, 300 reports (151 women and 149 men) were reviewed. Ages ranged from 6 to 82 yr (mean = 38.0, SD = 16.3). The majority of the patients had multiple skeletal areas examined. Most of the patients had X-rays of the spine (81.7%). Lytic bone changes, increased atlantodental intervals and fractures were among the more significant findings on the spinal films. A solitary pulmonary nodule and pneumonia was noted in the group of chest films. A vascular necrosis and fractures were important lesions found on the extremity films.

Although degenerative disc and posterior joint changes were by far the most prevalent findings, more significant lesions were noted. Lesions such as lytic bone changes, increased atlantodental intervals and the solitary pulmonary nodule represented lesions that necessitated further evaluation. The findings emphasize a need for chiropractic training to address the early recognition and preliminary work-up of these relatively common lesions.