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1.  RISK MANAGEMENT FOR CHIROPRACTORS AND OSTEOPATHS 
This article is the second in a series of articles dealing with risk management in the practise of chiropractic and osteopathy, prepared by the COCA Risk Management Subcommittee.
Background: Radiographic examination carries risks that must be weighed against the possible benefits when determining patient care.
Objective: The objective of this article is to propose guidelines for the use of imaging in chiropractic and osteopathic practice.
Discussion: Plain film radiography, CT scan, magnetic resonance imaging (MRI) and other forms of imaging are available for use in chiropractic and osteopathic practice in Australia. The astute practitioner utilises these imaging procedures for clinical decision making in order to make an accurate diagnosis that will determine a patient’s management. This article attempts to guide the practitioner in the proper use of these imaging procedures for different regions of the body.
PMCID: PMC2051318  PMID: 17987210
Chiropractic; risk management; osteopathy
2.  INJURIES IN AUSTRALIAN RULES FOOTBALL 
Background: Australian Rules Football is one of the most popular sports in Australia. Successful injury prevention relies on injury surveillance to establish the extent of injuries, to monitor injury patterns and to evaluate prevention strategies. Despite the popularity of participation at the community level, few injury surveillance studies have been published, so a detailed review of the literature is vital. There is limited information available outside of the elite level. Injury statistics for any professional sport may not necessarily be translatable to community sport level.
Objective: To document the most prevalent injuries at the elite, junior elite, amateur and junior level and determine if incidences differ across levels of play. Aetiology and significant risk factors for injuries are emphasized and prevention and treatment discussed.
Discussion: Injuries on average are more common at the elite level compared with other levels of participation. The type of injury varies slightly, with non contact injuries, particularly muscle strains, being the most common. Of these, the hamstring strain is the most common. Aetiology and risk factors vary between levels of play due to a time basis, physical development, speed of play and skill level. Recurrence rates are a concern for clubs and players, although rates are decreasing at the elite level, indicating better treatment and conservative management of injured players.
PMCID: PMC2051317  PMID: 17987211
Australian Rules Football; AFL; injuries
3.  BACTERIAL ARTHRITIS 
Acute pain in peripheral joints is not a common presenting symptom for chiropractors or osteopaths. However, chiropractors or osteopaths may be asked to assess peripheral joints when patients present with other conditions such as back pain.
This paper reviews the literature on bacterial arthritis as a specific type of infectious arthritis. Information was obtained from Medline and internet search using the keyword: “bacterial arthritis”. The most common presenting symptoms are described, with specific reference for chiropractors and osteopaths in clinical presentation of patients' with this condition.
PMCID: PMC2051089  PMID: 17987191
Bacterial arthritis; chiropractic
4.  SUBCLAVIAN STEAL SYNDROME 
The Subclavian Steal Syndrome is a condition that results from the stenosis or occlusion of the subclavian artery proximal to the origin of the vertebral artery. The blockage causes the reversal of the normal direction of blood flow in the vertebral artery which is termed the "steal", because it steals blood from the cerebral circulation. Blood is drawn from the contralateral vertebral, basilar or carotid artery regions into the low-pressure ipsilateral upper limb vessels. Although a relatively uncommon disease, it represents a condition which mimics many conditions often treated by chiropractors and osteopaths. The term subclavian steal syndrome is applied when reversed vertebral artery flow causes cerebral ischaemia with associated symptoms of vertebrobasilar hypoperfusion and/or symptoms of brainstem or arm ischaemia. This syndrome exists as an important consideration in the differential diagnosis of cerebral and brachial ischaemia.
PMCID: PMC2050636  PMID: 17989762
Chiropractic; osteopathy; dizziness; vertebrobasilar ischaemia; subclavian steal; artery

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