If duplex flow is normal, the patient should be eligable for cervical manipulation despite the positive premanipulative test. Assessment of published reliability studies for cervical spine range of motion measurement tools. In addition, citations were searched. A consultant rheumatologist and a physiotherapist were each asked to read a sample of the papers to give a clinical viewpoint. Measurement tools were found not to have been fully tested for reliability, particularly for adequate sample size and appropriate analysis techniques.
Further work needs to be performed on all measurement tools.
Researchers need to produce more rigorous studies and consider the issues discussed here. Nephrolithiasis with an unusual initial symptomatic presentation. Intervention and long-term management of nephrolithiasis are also presented. The initial urine dipstick was negative for hematuria, but a KUM revealed a smooth 2x3 mm stone lodged at the left vesicoureteral junction. The patient was referred to a regional university medical center and was to receive extracorporeal shock wave lithotripsy scheduled several days after his initial visit.