MSK

Question 1

Scoliosis seen in ..

Answer 1

PWS
Turners
Noonans
Marfans
NF-1
Skeletal dysplasias
CP
Spina bifida
Neuromuscular conditions

Question 2

Scoliosis exam

Answer 2

Growth, disproportion, US/LS ratio, arm span if tall
Neurocutaneous stigmata
Dysmorphology

BACK
-scars
- skin changes
- state if occiput directly ver buttock crease

Describe scoliosis
- thoracolumbar?
- to which side?
- which shoulder is higher?
- which scapulae is more prominant?
- loin crease symmetry?
- superior iliac spine position
- assymmetry in space between the arms

MANOUVERS
- bend forward and touch toes (confirms fixed scoliosis)
- sit on chair (thus no leg length discrepancy)
- pull upward on shoulders (straightens mobile component)

MOVEMENTS
- forward flexion
- extension
- lateral flexion
- rotation

• palpate over spine for tenderness

Lower and upper limbs
- tone power reflexes
- foot deformity
- if i had time id like to measure lower limb length to ascertain leg length discrepancy

STANDARD GAIT EXAM

Cardio resp exam
“there do not appear to be any complications of scoliosis such as restrictive lung disease “

Say would do tanner staging as scoliosis worsens in puberty

Investigations:
spirometry to assess for restrictive lung disease
Xray to assess cobb angle

pertinant findings are
- pre/post pubertal
- dysmorphic features suggestive of…
- left/right sided scoliosis
- scoliosis in the thoracolumbar region
- didnt appear to be positional or compensatory in nature