Intrapelvic calcifications are fairly common findings on AP lumbar views. This diagram lists some of the more frequent causes of calcification.
Phleboliths are very common and are a calcified thrombus within a vein. Most adults will have a few in the pelvic basin.
Arterial calcification in the large arteries such as the aorta and common iliac vessels represents the most common form of arterial calcification atherosclerosis.
Subcutaneous and intramuscular injections can cause fat necrosis which will also calcify, often seen in the gluteal region.
Peripheral mesenteric lymph nodes commonly will calcify after being involved in a previous infection.
Calcification can also be found in the prostate caused by renal calculi.
The vas deferens may calcify, but is usually found only in men with long standing diabetes.
Calcification is often found in uterine fibroids.
Calcification is frequently present in benign and malignant ovarian tumors.
Most calcifications found in the pelvis are relatively benign, however, if there is a concern that the calcification may involve a neoplastic process, a second opinion should be obtained. Many patients do not have significant clinical symptoms early on, therefore, the AP lumbar view may be the initial study that reveals the truly significant pathological process.
The proposed merger of the National Board of Chiropractic Examiners and Federation of Chiropractic Licensing Boards was approved by NBCE delegates and FCLB members at their respective annual meetings, held jointly in Atlanta, Ga., this year. Per the new bylaws, the new entity takes the NBCE name, with FCLB continuing as a department within NBCE. The federation will continue to enjoy Board of Directors representation on what will be a single, expanded board.
Before introducing subscapularis syndrome as an upper extremity analog, it is essential to revisit piriformis syndrome as a well-established example of myogenic pseudo-radiculopathy. Piriformis syndrome has long served as a clinical exception to disc-centric models of lower extremity pain and provides an important framework for understanding how deep muscular dysfunction can mimic radiculopathy in the absence of nerve root compression.
Pain has become the dominant language of musculoskeletal healthcare. Numeric pain-rating scales and symptom reports are routinely used as primary indicators of clinical success. But while pain reduction is meaningful, it is an incomplete and often misleading representation of recovery. This has real consequences for patient adherence, long-term outcomes, and how conservative care is perceived within the broader healthcare system.
