2003 Kurnik

This article titled Iliac nodular (or fibro-fatty nodules, known as back mice) disorder, Thoracolumbar syndorme and associated topics was published in 20013 in the magazine Dynamic Chiropractic.

Nodular disorder is a common low-back problem, but it is frequently MISDIAGNOSED or altogether UNIDENTIFIED.

Iliac Nodular Disorder, Thoracolumbar Syndrome and Associated Topics

By Joseph D. Kurnik


He mentions previous work of Dr. Warren Hammer in 1998. In that article the author mentioned several medical sources that referred to that disorder that had been treated by lidocaine and steroid injection or surgery. He mentioned the cluneal branch that crosses over the iliac crest through an osteofibrous tunnel. He called it an OSTEOFIBROUS DISORDER.

Kurnik referred to it as NODULAR DISORDER instead of osteofibrous disorder. He mentions that in the book Physical Examination of the Spine and Extremities (1976 edition), Stanley Hoppenfeld stated that “On occasions, fibro-fatty nodules may be found along the iliac crest. Such palpable enlargements are painful and very tender to the touch” -Stanley also mentioned “nodules” in the plural form.

fibro-fatty nodules


Kurnik refers that he has an extensive experience about these tender/painful NODULAR AREAS in patients he sees in his practice.

He thinks that the DISORDER is reported less frequently, overall, because of the lack of proper inspection. To explore them, Kurnik refers that the best way is by MASSAGING the area USING LOTION.

fibro-fatty nodules

Kurnik’s findings:

-The disorder usually presents more dramatically on ONE SIDE, but it can be bilateral.

-They vary in shape and size -they feel like enlarged lymph nodes that can move or they feel much larger, like a fusion of several nodules-. They feel like fluid-filled cyst-like structures. In general, they are between 1-3 cm.

-Other regions do not feel like nodular, they rather represent denser regions.

-The UPPER MEDIAL POSTERIOR CREST REGION is the most common site of such complaints.

-Sometimes they hurt all the time, other times with certain motions or by palpation.

KURNIK’s management:

-He had experimentally obtained patient’s relief by chiropractor therapeutics.

-He mentions that in case of extreme inflammation or irritation, massage would be contraindicated.

Other notes:

-Kurnik mentions that a careful examination could reveal that in the case of MAIGNE’S SYNDROME, there is also the presence of this nodular disorder.

-Kurnik considers that NODULAR disorder is related to spinal disorders. Kurnik questions as a chiropractor the origin of such nodular regions as being RELATED to JOINT FUNCTION or to AS ilium fixation. He relates that nodular disorder is related to “spinal associated disorders”.

Published in June 2018 by Marta Cañis Parera   ORCID iD icon