Module 24, General Orthopaedic Level

A 10 year old female presented with a spinal curvature which was first noted in a routine camp physical. She had no neurologic complaints. Her birth, medical, and developmental history were all unremarkable. Her family history was negative except there was a vague history of spinal curvature in the father. Physical examination was significant for a moderate left thoracic rib prominence, normal lower extremity reflexes, sensation and strength, but an absent abdominal reflexes in the upper and lower quadrants on the left side. A 24 degree left thoracic curve from T5 - Tl1 was measured.

Question 24A

The correct treatment of this curve is ordering an underarm custom molded TLSO, to be worn 23 hours per day.

Question 24B

The current treatment recommendations should include a series of back strengthening exercises.

Question 24C

Further work up of this girl should include obtaining an MRI scan of her whole spine.

Question 24D

This girl at age 10 with a positive family history and a 24 degree curve has approximately a 50 % risk of significant further progression..

Question 24E

A measure of this girl's rib hump would be a reasonable way to follow the progress of her scoliosis.

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