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24 Cards in this Set
- Front
- Back
most common curve in scoliosis
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right thoracic curve
(next most common is a double thoracolumbar curve) |
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most common etiology of scoliosis
sex-linked or autosomal dominant w/ variable expressivity and incomplete penetrance |
idiopathic (80%)
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complete unilateral congenital failure of formation
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hemivertebrae
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partial unilateral congenital failure of formation
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wedge vertebrae
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neuromuscular causes of scoliosis
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cerebral palsy
polio muscular dystrophy myelomeningocele spinal muscular atrophy Friedreich's ataxia |
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presentation of idiopathic scoliosis
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typically found during routine school exam
parents may notice that clothes do not hang correctly pain is usually NOT a symptom (search for the cause) |
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exam for scoliosis that must be done in order to prevent a misdiagnosis
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osteopathic structural examination
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quantitative measurements of the degree of scoliosis on X-rays
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Cobb angles
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indications for referral to orthopedics
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10-20 degree scoliosis, PCP can follow up
greater than 20 degrees, ortho will treat and follow up |
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goal of treatment of scoliosis
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prevent progression to 50 degrees at time of skeletal maturity (these curves tend to continue progressing)
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indications for bracing
How long is the brace worn |
usually for progressive curves of 20-45 degrees (don't need to brace those that don't progress)
Brace is worn for >16hr/day x 3-4yrs until skeltally mature |
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brace for mild to moderate scoliosis
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Milwaukee brace (only remove for bathing and skin care)
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brace used for curves with an apex below T10
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TLSO orthotic (Boston brace)
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brace involved in nighttime only program (better for adolescents)
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Charleston bending brace
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indication for surgical treatment
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curves greater than 50% or greater than 40% that are likely to progress
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use of electrical stimulation in treatment of scoliosis
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stimulate contralateral muscles, not much success
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characteristics of infantile scoliosis (0-3 years old)
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males > females
convexity to left (*unique) 85% resolve spontaneously |
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characteristics of juvenile scoliosis (4 to puberty)
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curves appear around ages 6 to 9
most progress steadily |
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characteristics of adolescent scoliosis (puberty to adulthood)
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most common presentation (80%)
females more likely to go to surgery (8:1) due to progression deformity increases w/ growth spurt |
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treatment for congenital scoliosis
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surgery (try to wait until older)
It will stop growth but patient is usually vertically challanged |
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two types of congenital failure of segmentation (bonding of 2 or more vertebrae)
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Unilateral unsegmented bar
Bilateral unsegmented (block vertebrae) |
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rising in the rib cage and/or swelling of the paravertebral musculature on one side
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Positive forward bending test
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what is essential in the Dx and Tx of scoliosis?
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X-rays and Cobb angle
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General principles for the managment of idiopathic scoliosis
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OMT
Observe and follow patient...may need referral to ortho |