Module 9, General Orthopaedist Level
A 14 month old child was brought for evaluation because of low posterior
hair line, short neck and limited neck ROM. He was the product of a normal
pregnancy and delivery. Mother was also concerned because he holds his
head to one side. Physical examination demonstrated an elevated shoulder
on the right and very limited side bending of the neck to either side although
he held his head slightly cocked to the left. An x-ray was obtained which
demonstrated a complex posterior fusion mass and an elevated scapula on
the right.
Question 9A
Further work up is indicated with an MRI at this time.
Question 9B
Scoliosis
is likely to develop in the thoracic spine.
Question 9C
The
anterior column appears relatively normal on the x-rays therefore this
means that the fused segments are mainly posterior.
Question 9D
Sprengel's
deformity is associated with Klippel-Feil syndrome.
Question 9E
This
congenital deformity occurred in the first trimester of pregnancy.
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