THORACIC Scheurmann's disease Flashcards
1
Q
Schuermann’s classic presentation
A
young boy b/w 13-17 comes in with mid back pain and fatigue
- noticeable hyperkyphosis and inc. pain on activity
2
Q
similar DDX’s
A
- postural kyphosis
- scoliosis
- ankylosing spondylitis
3
Q
supporting factors
A
- family history
- rapid growth spurts in adolescence
- hyperkyphosis or poor posture
- fatigue
- pain worsens with activity
4
Q
refuting factors
A
- kyphosis resolves with ext. or lying prone
- kyphosis is less than 40 degrees
- patient is younger than 10
5
Q
relevant orthos
A
- adam’s test is scoliosis is present
6
Q
referrals
A
- lateral x-rays for thoracic kyphosis
- can diagnose if there is a hyperkyphosis of more than 40 degrees with consecutive wedging of 5 degrees in 3 or more vertebrae
7
Q
contraindications
A
- if spinal fusion surgery - DO NOT ADJUST
8
Q
technique
A
adjust to patient tolerance
9
Q
care plan
A
2 x a week for 4 weeks
10
Q
recommendations
A
- strengthen back muscles and stretch ant. ones
- stretch hamstings
- physical therapy
- bracing and PT if curve is b/w 60-80 degrees and symptomatic
- spinal fusion surgery if curve is more than 75 degrees
11
Q
prognosis
A
- good
