The patient was a 27-year-old man who was referred to a physical therapist because of persistent right wrist pain after a fall on an outstretched hand in a remote setting 3 months prior. Immediately after the injury, the patient was seen by a physician's assistant in a remote medical clinic, where right wrist radiographs were completed and interpreted as normal. Based on the history and physical exam, a potential scaphoid fracture was suspected.
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Background: The use of spinal manipulation as a treatment to facilitate neuromuscular control of the paraspinal musculature is not well described in the literature. The use of rehabilitative ultrasound imaging (RUSI) may offer a convenient way to investigate and document possible changes occurring in the lumbar multifidus associated with manipulation intervention.