Module 26, General Orthopaedist Level

This male child initially presented at age 3 with multiple cafe-au-lait spots larger than 1.5 cm and nodules especially on the left flank. At the age of eleven years old he presented with a complaint of thoracic back pain (1991) after two years of observation of a thoracic scoliosis. At his first visit the patient was diagnosed with a kyphoscoliosis that measured 62 degrees of a right thoracic T3-T7 curve and a 62 degree thoracic kyphosis.

Question 26A

The posterior vertebral body scalloping and enlarged foramina are consistent with neurofibromatosis.

Question 26B

After the history and physical an MRI of the spinal cord is the next indicated test.

Question 26C

Dural ectasia was found on MRI. This will make consideration of spine fusion very difficult.

Question 26D

The kyphoscoliosis that measured at 62 degrees of a right thoracic T3-T7 curve. Immediate bracing is indicated.

Question 26E

At this young age spinal fusion should be avoided to prevent stunting of growth.

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