MSK: Scoliosis Flashcards
What is scoliosis?
A lateral curvature in the frontal plane of the spine
In structural scoliosis, there is rotation of…
The vertebral bodies which causes a prominence in the back from rib asymmetry
In most cases are the changes mild or severe?
Mostly mild and pain free = primarily a cosmetic problem
In severe cases, what can the curvature lead to?
Cardio respiratory failure from chest distortion
What is the most common cause?
Idiopathic - either early onset < 5 years old or late onset - mainly in girls 10-14 during pubertal growth spurt
Describe the congenital form
From a congenital structural defect of the spine e.g hemivertibra, spina bifida
What secondary causes are there?
Related to other disorders e.g neuromuscular imbalance (cerebral palsy, muscular dystrophy)
Disorders of bone - neurofibromatosis
Connective tissue disorders - marfans
Leg length discrepancy- arthritis of one knee in Juvenile idiopathic arthritis
What should be done on examination?
Inspect child’s back when standing up straight - in mild scoliosis there may be irregular skin creases and difference in shoulder height
Scoliosis can be identified by examining child’s back when bent forward (if scoliosis disappears on bending forward, it is postural)
Does mild scoliosis resolve spontaneously?
Yes or progresses minimally
If it is more severe, the severity and progression is determined by…
X ray
How are severe cases managed?
Bracing
Surgery only if severe or coexisting pathology e.g neuromuscular or respiratory disease
What is the most common pattern of scoliosis?
A right convex curvature of the thoracic spine - forward rotation and protrusion of right shoulder
When is the peak incidence ?
10-12 years
