Module 28, Pediatric Orthopaedist Level
The patient is a 4 year old male who developed an insidious onset of
neck pain and stiffness 4 days prior to admission. Over the intervening
period, the patient suffered from worsening of his symptoms which led to
increasing irritability and difficulty sleeping. On the day of admission,
he developed severe neck pain. It was observed that his head was in a fixed
position just slightly right of midline. The patient's past medical history
was remarkable for two recent self-limited episodes of hives and urticaria
on his trunk and extremities that was treated with prednisone. There was
vague history of remote trauma about one month previously when the patient
had been "horsing" around with his brother. The child had no
evidence of a viral prodrome, constitutional symptoms or travel history.
Question 28A
The
most common outcome of this process is auto fusion of the calcified disc
spaces over approximately 3 months period of time.
Question 28B
This
condition can cause disc protrusion severe enough to cause spinal cord
symptoms.
Question 28C
Soft
cervical collars, anti-inflammatory medication and anti-spasmotic medication
are the main stays of treatment. Treatment can be discontinued when the
patient is asymptomatic.
Question 28D
The
anatomic location of this calcification is in the nucleus pulposus.
Question 28E
Disc
calcification in children is more common in boys.
Go to Next Question Module, Go
to General Orthopaedist Level Modules, Go
to Question Module Home Page, Go
to Case Presentation Home Page, Orthopaedic
Department Home Page.
