The Medical journal of Australia
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Adult epiglottitis is a disease that is well known to otolaryngologists, but is less commonly encountered in general medical practice. It is being recognized with increasing frequency, and in many respects is different from paediatric epiglottitis. Three patients with adult epiglottitis are described, with an emphasis on the variation in clinical presentation and the difficulty in diagnosis. The appropriate examinations and the management of the disease are discussed.
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The ability of a manipulative therapist to diagnose symptomatic cervical zygapophysial joint syndromes accurately was evaluated in a series of 20 patients. In 11 patients the presence, or absence, of a symptomatic joint was established by means of radiologically-controlled diagnostic nerve blocks. These patients were assessed by the manipulative therapist, without knowledge of the medical diagnosis. ⋯ None of the five patients with asymptomatic joints was misdiagnosed as having symptomatic zygapophysial joints. Thus, manual diagnosis by a trained manipulative therapist can be as accurate as can radiologically-controlled diagnostic blocks in the diagnosis of cervical zygapophysial syndromes. However, before generalized claims about the reliability of manual diagnosis can be made, further studies of this nature are required to validate intertherapist reliability and the ability of manual techniques to diagnose other spinal pain syndromes.