Thoracic Dysfunction

Question 1

Describe discogenic pain in the T-Spine

Answer 1

• Non symptomatic
• Non-traumatic
• Common at T11/12
• Band like pain around chest
• Central of lateral prolapse can produce symptoms of myelopathy, radiculopathy and radicular pain

Question 2

Describe symptoms associated with spondylotic change

Answer 2

• Dull and local pain
• intermittent pain
• occasional acute episodes

Question 3

Inspiration lesions:

Answer 3

• Ribs held in inspiration = held up

- Sore with forced exhalation (cough)

Question 4

Expiration lesions:

Answer 4

• Ribs held in expiration = depressed or down

- Sore with inhalation

Question 5

Which joints become inflamed in Costochondritis

Answer 5

Inflammation of costochondral or costosternal joints.

Question 6

What are Schmorls Nodes?

Answer 6

• Fracture of the end plate can cause disc herniation and become encapsulated and calcified
• Happens due to weak end plates and disc strength
• Asymptomatic
• Commmon in adolescents
• Disc height is not lost

Question 7

Describe the clinical features of Scheurmanns disease (juvenile kyphosis)

Answer 7

• Thoracic Deformity

- Pain with specific onset

Question 8

Describe the effects of Scheurmanns disease on the T-Sp

Answer 8

• Causes unclear but related to metabolic and endocrine abnormalities
• Thick ALL
• Wedge shaped bodies
• narrow width of IVDs

Question 9

What could be some complications and sequelae of Scheurmanns disease

Answer 9

Sequelae

• Could lead to LBP, Tsp Pain
• Functional adaptive problems

Complications

• spondylolysis/lysthesis
• Cord compression (rare)

Question 10

What type of curvature is seen in Scoliosis?

Answer 10

Abnormal lateral curvature of the spine

Question 11

What could be some reasons for scoliosis?

Answer 11

a) Short lower extremity
b) Pelvic asymmetry/ uneven sacral base
c) Postural demands (heavy head maybe?)
d) Previous spinal pathology

Question 12

How do you measure the severity and progression of scoliosis?

Answer 12

Cobbs angle is used to measure the severity and progression

Question 13

Describe 3 variants of kyphosis

Answer 13

• Round Back
– Decreased pelvic inclination
– Adaptive changes secondary to postural demands

• Gibbus
– Structural
– Due to a fracture, tumour or bone disease.

• Dowagers hump
– Due to postmenopausal osteoporosis and consequent anterior wedge fractures.