Objective: To review a case of an atypical presentation of abdominal aortic aneurysm.
Clinical Features: A 58-year-old, non-smoking male presented with 2 to 3 weeks of low back pain localized to the right fourth and fifth lumbar vertebrae area.
Interventions and Outcomes: Surface electromyography revealed increased muscle tension in the lumbar spine measuring 3 to 6 times normal values. Radiographic examination revealed calcification of the abdominal aorta which measured 8.5 cm in diameter. An immediate referral was made to the emergency room for suspicion of an abdominal aortic aneurysm. The ER did not evaluate the patient and it took a phone call by the chiropractor to get the patient back to the ER where an ultrasound was finally performed revealing a hemorrhaging abdominal aortic aneurysm.
Conclusions: This case highlights how life-threatening conditions may mimic common musculoskeletal conditions. Practicing chiropractors must assess each case without preconceived notions. Additionally, a comprehensive evaluation is essential to chiropractic care.
Author keywords: Abdominal aortic aneurysm, chiropractic, low back pain, Paraspinal Surface Electromyography, sEMG, vertebral subluxation, Radiography, X-ray, Chiropractic BioPhysics®, CBP®
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