Bibliographic record
Abstract
OBJECTIVE: To highlight the unusually indolent course of avascular necrosis in this patient, the risk factors of which chiropractors should be aware, the necessity of and means to an early diagnosis, the limitations of plain film radiographs, as well as the current medical treatments. CLINICAL FEATURES: A 27-year-old male professional soccer player had a tight and achy right hip for approximately 6 years, a condition that increased with physical activity. His active range of motion was limited by 25% in extension and abduction, and all resisted ranges of motion produced pain. After an equivocal radiograph and bone scan, magnetic resonance imaging revealed a subchondral defect located on the superior aspect of the right femoral head, consistent with avascular necrosis of the femoral head. INTERVENTION AND OUTCOME: Presurgical management included Cybex testing, massage, myofascial release, interferential current, muscle strengthening, and muscle balancing exercises 3-5 times per week for 5 months. The patient underwent a curette procedure. Six weeks later, he returned to the chiropractic office for postsurgical rehabilitation, in which he is still involved today. He has made progress with respect to flexibility, strength, and muscle coordination. CONCLUSIONS: Idiopathic avascular necrosis of the hip is a clinical entity characterized by pain in the hip made worse with activity and at night, which may radiate to the groin, back, or thigh. Often, physical exam and radiographic findings are equivocal, at which point advanced imaging such as magnetic resonance imaging should be ordered to identify the disease in its earliest stages.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.002 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.002 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".