Guest guest Posted August 28, 2006 Report Share Posted August 28, 2006 In a message dated 8/28/2006 6:37:29 PM US Mountain Standard Time, jallan2@... writes: I seem to recall a correlation between low back P and lipoma (located in the PSIS/SI joint area). Just make sure its truly lipoma - I know of a DC who was told by another DC that the lump in his back was a lipoma and it turned out to be a malignancy. Anglen Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 28, 2006 Report Share Posted August 28, 2006 Be prudent but don’t practice afraid. ( E. Abrahamson, D.C.) Chiropractic physician Lake Oswego Chiropractic Clinic 315 Second Street Lake Oswego, OR 97034 503-635-6246 Website: http://www.lakeoswegochiro.com From: <ang320@...> Date: Mon, 28 Aug 2006 23:01:04 EDT <jallan2@...>, < > Subject: Re: Low back P & Lipoma In a message dated 8/28/2006 6:37:29 PM US Mountain Standard Time, jallan2@... writes: I seem to recall a correlation between low back P and lipoma (located in the PSIS/SI joint area). Just make sure its truly lipoma - I know of a DC who was told by another DC that the lump in his back was a lipoma and it turned out to be a malignancy. Anglen Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 29, 2006 Report Share Posted August 29, 2006 Lipomas are movable, not attached to the base structures....anything else needs to be treated with suspect. Sunny Sunny Kierstyn, RN DC Fibromyalgia Care Center of Oregon 2677 Willakenzie Road, 7C Eugene, Oregon, 97401 541- 344- 0509; Fx; 541- 344- 0955 From: Abrahamson <drscott@...><ang320@...>,<jallan2@...>,< >Subject: Re: Low back P & LipomaDate: Mon, 28 Aug 2006 20:14:00 -0700 Be prudent but don’t practice afraid.( E. Abrahamson, D.C.)Chiropractic physicianLake Oswego Chiropractic Clinic315 Second StreetLake Oswego, OR 97034503-635-6246Website: http://www.lakeoswegochiro.com From: <ang320@...>Date: Mon, 28 Aug 2006 23:01:04 EDT<jallan2@...>, < >Subject: Re: Low back P & Lipoma In a message dated 8/28/2006 6:37:29 PM US Mountain Standard Time, jallan2@... writes:I seem to recall a correlation between low back P and lipoma (located in the PSIS/SI joint area).Just make sure its truly lipoma - I know of a DC who was told by another DC that the lump in his back was a lipoma and it turned out to be a malignancy. Anglen Check the weather nationwide with MSN Search: Try it now! Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 29, 2006 Report Share Posted August 29, 2006 Biopsy anyone? Dr. Ray --------- Re: Low back P & Lipoma In a message dated 8/28/2006 6:37:29 PM US Mountain Standard Time, jallan2earthlink (DOT) net writes:I seem to recall a correlation between low back P and lipoma (located in the PSIS/SI joint area).Just make sure its truly lipoma - I know of a DC who was told by another DC that the lump in his back was a lipoma and it turned out to be a malignancy. Anglen Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 29, 2006 Report Share Posted August 29, 2006 Hey all. I'd like to chime in on this. I had a patient once come and tell me her primary had injected her "trigger point" in her low back that had been bothering her. It made her a lot worse. They seemed to be the source of her back pain, and upon exam I thought they were presacral lymph nodes or lipomas....wasn't sure which. I sent her to a MD in Lake Oswego, who told me he was 4 for 4 in removing them and having pain go away. Lipoma's are usually painless. When they are leiomyoma's they are innervated, or when they are leiomyofibromas. There are also myolipomas, which may be the general term for the fat and muscle tissue mixed in the benign form. They both contain muscles and ffatty/fibrous connective tissue. Anyway, that's what they biopsied out as. This doctor told me the ones with the muscle are painful, and the ones just fat are not. Made since. Patient was asymptomatic after the procedure!!! . He said he's never really found anything in the literature on this "phenomenon", and that we should write it up. We didn't. It made since theoretically. IN addition, I'll always wonder if it was really it or if she responded due to him "cutting out" her pain (like the MD at the INternational Whiplash Congress talked about). Don WHite, RN, DC Canyon Rd Chiropractic & Massage BEaverton, OR 97005 P.S. I wouldn't bank on the thing about the lipoma being freely moveable. Some of them can have a stalk and be attached. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 29, 2006 Report Share Posted August 29, 2006 If the nodule is moblie, the biopsy will be seen as overkill. sk Sunny Kierstyn, RN DC Fibromyalgia Care Center of Oregon 2677 Willakenzie Road, 7C Eugene, Oregon, 97401 541- 344- 0509; Fx; 541- 344- 0955 From: mottray@...To: Abrahamson <drscott@...>, <ang320@...>, <jallan2@...>, < >Subject: Re: Low back P & LipomaDate: Tue, 29 Aug 2006 19:53:25 +0000 Biopsy anyone? Dr. Ray --------- Re: Low back P & Lipoma In a message dated 8/28/2006 6:37:29 PM US Mountain Standard Time, jallan2earthlink (DOT) net writes:I seem to recall a correlation between low back P and lipoma (located in the PSIS/SI joint area).Just make sure its truly lipoma - I know of a DC who was told by another DC that the lump in his back was a lipoma and it turned out to be a malignancy. Anglen Check the weather nationwide with MSN Search: Try it now! Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 29, 2006 Report Share Posted August 29, 2006 YES YES, alright already, I neglected to mention, he's already been to dermatologist to confirm the dx of lipoma. He's had them for years and he gets them checked regularly with his annual exams. They haven't changed in size, they are movable, well circumscribed etc..... etc....... I simply remember that I saw somewhere a research study indicating there was a correlation with low back P and lipomas and I was wondering if anyone else saw it, remembers it, knows it or has an opinion regarding this correlation. Judith Allan LO, OR Re: Low back P & Lipoma > >Biopsy anyone? > >Dr. Ray > >--------- Re: Low back P & Lipoma > > > > > >In a message dated 8/28/2006 6:37:29 PM US Mountain Standard Time, jallan2@... writes: > >I seem to recall a correlation between low back P and lipoma (located in the PSIS/SI joint area). > > >Just make sure its truly lipoma - I know of a DC who was told by another DC that the lump in his back was a lipoma and it turned out to be a malignancy. > > Anglen > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 29, 2006 Report Share Posted August 29, 2006 As identified below, there are several different types of lipomas with the most common being the superficial subcutaneous lipoma which are mobile and soft. However, it seems as if the one in question is the lumbosacral lipoma which can be associated with spina bifida. While it is not always necessary, a biopsy will determine the nature of this mass. While you shouldn't practice in fear, if you don't know what a mass is, then you had better find out. If you practice the full scope of chiropractic practice in Oregon (which I'm not sure anybody does) then you can biopsy and even remove this yourself. Otherwise you should document referral of the patient to a medical physician who will do this or at least confirm the benign diagnosis of a lipoma and take responsibility for following it. Other types of lipomas will not be as mobile due to their tissue of origina (see below). I would suspect that a lumbosacral radiograph series is sufficient to rule out spina bifida in this adult individual but if there is any question as to the nature of the mass or possibly associated symptoms, further diagnostic workup and or referral is appropriate. W , D.C, M.D, Cascades East Family Medicine Klamath Falls, Oregon __________________________________________________________________________ Lipoma (From Penn State: http://www.hmc.psu.edu/healthinfo/jkl/lipoma.htm ) What is it? Lipoma is a common soft-tissue tumor found under the skin but also can appear in deeper tissues and even in various body organs, such as the heart, brain, and lung. They can vary from walnut size to that of a large baseball and usually have a soft, rubbery feel. Types of lipomas include the superficial subcutaneous lipoma, the intramuscular lipoma, the spindle cell lipoma, the angiolipoma, the benign lipoblastoma, and the lipomas of tendon sheaths, nerves, synovium, periosteum, and the lumbosacral area. The most common type is the superficial subcutaneous lipoma. Who gets it? Superficial subcutaneous lipomas occur more frequently in women than men, usually on the trunk, nape of the neck, and forearms. They are found more commonly in people who are overweight, although losing weight will not make lipomas smaller. Deep intramuscular lipomas usually affect adults 30 to 60 years of age, with more men being affected than women. It is commonly found in the large muscles of the extremities. Spindle cell lipomas are seen typically in men 45 and 64 years of age in the posterior neck and shoulder areas. Angiolipoma lipomas are usually found in young adults, typically on the forearm. Lumbosacral lipomas occur in the trunk posterior to a spina bifida defect. They usually occur in infants, but can be seen in adults. An extremely rare variation of lipoma is diffuse lipomatosis. Symptoms include multiple superficial and deep lipomas that involve one entire extremity or the trunk and usually have their onset during the first 2 years of life. Benign lipoblastoma and diffuse lipoblastomatosis usually affect the extremities of infants. The lesions can be solitary or multiple and can be superficial or deep in muscle tissue. What causes it? No one knows why lipomas occur. Usually they are inherited. What are the symptoms? Symptoms of lipoma include soft, moveable lumps under the skin that are sometimes painful to the touch. How is it diagnosed? The doctor may be able to make a diagnosis of lipoma based on a visual examination of the patient. The doctor may also do a biopsy on the lesion to determine the type of lipoma. What is the treatment? Treatment for lipomas may not be required, however in most cases they can be surgically removed if they are very large, painful, or cosmetically unattractive. The doctor may remove them by surgical excision. Liposuction can sometimes be performed and may result in less scarring. Sometimes it is impossible to remove a diffuse lipomatosis if the involved limb becomes massive in size. In this extreme case, amputation of the limb may be recommended. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 29, 2006 Report Share Posted August 29, 2006 Of course, since it has not been written up, there is no evidence. Without evidence you can’t support such care. In these times of evidence based care you cannot treat this patient. (Or at least you won’t be paid for services!) J Seitz, DC Tuality Physicians 730-D SE Oak Street Hillsboro, OR 97123 (503)640-3724 From: [mailto: ] On Behalf Of MekaAbou@... Sent: Tuesday, August 29, 2006 5:25 PM bradandange@...; Subject: Re: Low back P & Lipoma Hey all. I'd like to chime in on this. I had a patient once come and tell me her primary had injected her " trigger point " in her low back that had been bothering her. It made her a lot worse. They seemed to be the source of her back pain, and upon exam I thought they were presacral lymph nodes or lipomas....wasn't sure which. I sent her to a MD in Lake Oswego, who told me he was 4 for 4 in removing them and having pain go away. Lipoma's are usually painless. When they are leiomyoma's they are innervated, or when they are leiomyofibromas. There are also myolipomas, which may be the general term for the fat and muscle tissue mixed in the benign form. They both contain muscles and ffatty/fibrous connective tissue. Anyway, that's what they biopsied out as. This doctor told me the ones with the muscle are painful, and the ones just fat are not. Made since. Patient was asymptomatic after the procedure!!! He said he's never really found anything in the literature on this " phenomenon " , and that we should write it up. We didn't. It made since theoretically. IN addition, I'll always wonder if it was really it or if she responded due to him " cutting out " her pain (like the MD at the INternational Whiplash Congress talked about). Don WHite, RN, DC Canyon Rd Chiropractic & Massage BEaverton, OR 97005 P.S. I wouldn't bank on the thing about the lipoma being freely moveable. Some of them can have a stalk and be attached. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 30, 2006 Report Share Posted August 30, 2006 Hey Judith check this out: http://www.chiroweb.com/archives/18/19/04.html Dr. ph Medlin D.C. Spine Tree Chiropractic 1627 NE Alberta St. #6 Portland, OR 97211 Ph: 503-788-6800 c: 503-889-6204 Re: Low back P & Lipoma > > > > > >In a message dated 8/28/2006 6:37:29 PM US Mountain Standard Time, >jallan2@... writes: > >I seem to recall a correlation between low back P and lipoma (located in >the PSIS/SI joint area). > > >Just make sure its truly lipoma - I know of a DC who was told by another DC >that the lump in his back was a lipoma and it turned out to be a >malignancy. > > Anglen > > > > OregonDCs rules: 1. Keep correspondence professional; the purpose of the listserve is to foster communication and collegiality. No personal attacks on listserve members will be tolerated. 2. Always sign your e-mails with your first and last name. 3. The listserve is not secure; your e-mail could end up anywhere. However, it is against the rules of the listserve to copy, print, forward, or otherwise distribute correspondence written by another member without his or her consent, unless all personal identifiers have been removed. Quote Link to comment Share on other sites More sharing options...
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